Zullig Leah L, Smith Valerie A, Jackson George L, Danus Susanne, Schnell Merritt, Lindquist Jennifer, Provenzale Dawn, Weinberger Morris, Kelley Michael J, Bosworth Hayden B
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC; Division of General Internal Medicine, Duke University Medical Center, Durham, NC.
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC; Division of General Internal Medicine, Duke University Medical Center, Durham, NC.
Clin Colorectal Cancer. 2016 Dec;15(4):e199-e204. doi: 10.1016/j.clcc.2016.04.005. Epub 2016 May 7.
Colorectal cancer (CRC) is a common and potentially deadly disease. Although the United States has robust cancer data reporting, information from the Department of Veterans Affairs (VA) healthcare system has often been underrepresented in national cancer data sources. We describe veterans with incident CRC in terms of their patient and tumor characteristics and mortality.
Patients diagnosed or treated with CRC at any VA institution in the fiscal years 2009 to 2012 were identified using 3 data sources: (1) VA Central Cancer Registry (VACCR); (2) VA Corporate Data Warehouse; and (3) VA Reports and Measures Portal. The CRC frequencies within the VA population and survival curves were examined descriptively and compared with the national projections using Surveillance, Epidemiology, and End Results program data.
A total of 12,551 veterans with CRC were included in the present analysis. The median age at diagnosis was 65.5 years. Approximately 97% (n = 12,229) of the CRC cases were diagnosed among men. Approximately 44% (n = 5517) of the patients were diagnosed with localized disease. The 3-year survival rate was associated with age (P < .01) and stage (P < .01) at diagnosis. We identified a possible decrease in VA CRC incidence over time.
Although the VA CRC patient population was heavily skewed toward the male gender, the patient and tumor characteristics were similar between the incident CRC cases reported by the VACCR and those reported to the Surveillance, Epidemiology, and End Results program. This suggests that research findings resulting from the VACCR might have applicability beyond the VA healthcare system setting.
结直肠癌(CRC)是一种常见且可能致命的疾病。尽管美国有完善的癌症数据报告,但退伍军人事务部(VA)医疗系统的信息在国家癌症数据来源中往往未得到充分体现。我们根据患者和肿瘤特征及死亡率描述了患新发结直肠癌的退伍军人情况。
利用3个数据源确定了2009财年至2012财年在任何VA机构被诊断或接受结直肠癌治疗的患者:(1)VA中央癌症登记处(VACCR);(2)VA企业数据仓库;(3)VA报告与措施门户网站。对VA人群中的结直肠癌发病率和生存曲线进行了描述性研究,并与使用监测、流行病学和最终结果计划数据得出的国家预测结果进行了比较。
本分析共纳入12551例患结直肠癌的退伍军人。诊断时的中位年龄为65.5岁。约97%(n = 12229)的结直肠癌病例在男性中被诊断出。约44%(n = 5517)的患者被诊断为局限性疾病。3年生存率与诊断时的年龄(P < 0.01)和分期(P < 0.01)相关。我们发现VA结直肠癌发病率可能随时间下降。
尽管VA结直肠癌患者群体严重偏向男性,但VACCR报告的新发结直肠癌病例与向监测、流行病学和最终结果计划报告的病例之间的患者和肿瘤特征相似。这表明VACCR得出的研究结果可能在VA医疗系统环境之外具有适用性。