Background:
Adjuvant chemotherapy is an important component of treatment for stage III colorectal cancer patients. We investigated patterns of treatment in Queensland for patients diagnosed with colorectal cancer during the period 2010 to 2014.
Methods:
Incident cases of colorectal cancer diagnosed between 2010 and 2014 were sourced from the Queensland Oncology Repository (QOR). Patients were staged at diagnosis using TNM data from treatment systems. Data from 2012 and 2014 were augmented with information obtained by auditing pathology reports. Data was limited to those patients receiving intravenous (IV) chemotherapy.
Results:
Over 14,500 patients were diagnosed with colorectal cancer during the five year period. 22 percent of all patients were classified as having stage III disease. Stage was unknown for eight percent of patients, though this was lower in the two years with supplemented data (3% and 5% respectively).
Surgery was performed on over 95% of patients with stage III disease. Adjuvant chemotherapy was delivered to 58% of patients in this cohort (Colon 55%, Rectal 61%). Chemotherapy rates ranged from 89% for patients aged in their 30s to 17% for those aged 80 and over. Median age for patients receiving chemotherapy was 64. Chemotherapy rates decreased with increasing number of comorbidities (0: 63%, 1: 49%, 2+: 35%). 58% of urban patients received chemotherapy compared with 56% of patients from rural areas. Survival rates were higher among patients receiving chemotherapy at one year (96% vs 82%), two years (87% vs 71%) and five years (73% vs 56%).
Conclusions:
Chemotherapy is being delivered in an appropriate, targeted manner to Queensland colorectal cancer patients. Utilisation rates compare favourably with those reported internationally1 and were highest among younger patients and those with no comorbidities. Reassuringly, rural patients were able to access chemotherapy in similar numbers to those living in urban areas.