Marked improvements in survival of patients with rectal cancer in the Netherlands following changes in therapy, 1989–2006
Section snippets
Background
Each year, over 3000 new cases of rectal cancer are diagnosed in the Netherlands, with age-standardised incidence rates (European Standard Population, ESR) increasing between 1989 and 2006 from 12.0 to 15.5 per 100,000 person-years. Incidence rates were higher for males than for females (ESR 19.6 versus 11.3 per 100,000 person-years in 2006).1
Previous regional Dutch studies have shown improved survival of patients with rectal cancer since 1980.2, 3 Especially since the mid 1990s, this
Data collection
Population-based data from the nationwide Netherlands Cancer Registry (NCR), which was started in 1989 and is maintained and hosted by the Comprehensive Cancer Centres, were used. The NCR is based on notification of all newly diagnosed malignancies in the Netherlands by the automated pathological archive (PALGA). Additional sources are the national registry of hospital discharge diagnoses, haematology departments and radiotherapy institutions.1 Information on patient characteristics, such as
Results
During the period 1989–2006, 40,888 patients were diagnosed with rectal cancer. The proportion of patients aged 45–59 years increased over time, while the proportion of patients aged 75+ years decreased. During this period, the proportion of patients with stage II disease decreased, whereas the proportion of patients with stages III and IV disease increased (Table 1). The age-standardised incidence rate (ESR) increased over time, whereas the age-standardised mortality rate decreased (Fig. 1).
Discussion
This nationwide population-based study focussed on trends in treatment and survival of patients with rectal cancer in the Netherlands during the period 1989–2006. There were several changes in treatment, which contributed to an improvement in survival, particularly for patients with stage III rectal cancer.
The incidence of rectal cancer increased in the Netherlands whereas the mortality decreased, pointing to an increase in survival possibly caused by effective treatment.15 However, there were
Conflict of interest statement
None declared.
Acknowledgements
The work on this research was performed within the framework of the project ‘Progress against cancer in the Netherlands since the 1970s?’ (Dutch Cancer Society Grant 715401). The authors thank the working group Output (Dr. K. Aben, R. Damhuis, Dr. J. Flobbe, M. van der Heiden, Dr. P. Krijnen, Dr. L. van de Poll, Dr. S. Siesling, J. Verloop) of the NCR for providing data from the cancer registry and the registration clerks for their dedicated data collection.
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