Colon and rectal cancer survival by tumor location and microsatellite instability: The colon cancer family registry

Amanda I. Phipps, Noralane Morey Lindor, Mark A. Jenkins, John A. Baron, Aung Ko Win, Steven Gallinger, Robert Gryfe, Polly A. Newcomb

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: Cancers in the proximal colon, distal colon, and rectum are frequently studied together; however, there are biological differences in cancers across these sites, particularly in the prevalence of microsatellite instability. Objective: We assessed the differences in survival by colon or rectal cancer site, considering the contribution of microsatellite instability to such differences. Design: This is a population-based prospective cohort study for cancer survival. SETTINGS: This study was conducted within the Colon Cancer Family Registry, an international consortium. Participants were identified from population-based cancer registries in the United States, Canada, and Australia. PATIENTS: Information on tumor site, microsatellite instability, and survival after diagnosis was available for 3284 men and women diagnosed with incident invasive colon or rectal cancer between 1997 and 2002, with ages at diagnosis ranging from 18 to 74. Main Outcome Measures: Cox regression was used to calculate hazard ratios for the association between all-cause mortality and tumor location, overall and by microsatellite instability status. Results: Distal colon (HR, 0.59; 95% CI, 0.49-0.71) and rectal cancers (HR, 0.68; 95% CI, 0.57-0.81) were associated with lower mortality than proximal colon cancer overall. Compared specifically with patients with proximal colon cancer exhibiting no/low microsatellite instability, patients with distal colon and rectal cancers experienced lower mortality, regardless of microsatellite instability status; patients with proximal colon cancer exhibiting high microsatellite instability had the lowest mortality. Limitations: Study limitations include the absence of stage at diagnosis and cause-of-death information for all but a subset of study participants. Some patient groups defined jointly by tumor site and microsatellite instability status are subject to small numbers.

Original languageEnglish (US)
Pages (from-to)937-944
Number of pages8
JournalDiseases of the Colon and Rectum
Volume56
Issue number8
DOIs
StatePublished - Aug 2013

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Microsatellite Instability
Rectal Neoplasms
Colonic Neoplasms
Registries
Survival
Neoplasms
Colon
Mortality
Rectum
Population
Canada
Cause of Death
Cohort Studies
Outcome Assessment (Health Care)
Prospective Studies

ASJC Scopus subject areas

  • Gastroenterology

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Colon and rectal cancer survival by tumor location and microsatellite instability : The colon cancer family registry. / Phipps, Amanda I.; Lindor, Noralane Morey; Jenkins, Mark A.; Baron, John A.; Win, Aung Ko; Gallinger, Steven; Gryfe, Robert; Newcomb, Polly A.

In: Diseases of the Colon and Rectum, Vol. 56, No. 8, 08.2013, p. 937-944.

Research output: Contribution to journalArticle

Phipps, Amanda I. ; Lindor, Noralane Morey ; Jenkins, Mark A. ; Baron, John A. ; Win, Aung Ko ; Gallinger, Steven ; Gryfe, Robert ; Newcomb, Polly A. / Colon and rectal cancer survival by tumor location and microsatellite instability : The colon cancer family registry. In: Diseases of the Colon and Rectum. 2013 ; Vol. 56, No. 8. pp. 937-944.
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