Introduction To describe the trends in colon and rectal cancer incidence, management and mortality in Ukraine. To compare the distribution of operations for colon and rectal cancer in the major referral hospital in Ukraine and a United States tertiary care centre.
Method This is a population based study of colorectal cancer incidence, mortality and management in Ukraine over 14 years (1999–2012). The National Cancer Registry of Ukraine was queried for incidence, overall and 1 year mortality, stage at presentation and management. The distribution of operative interventions for colorectal cancer performed at the National Cancer Institute in Ukraine a 560-bed, major referral centre for oncologic surgery as compared to the Brigham and Women’s Hospital, 779-bed tertiary care centre in the US will be reported here.
Results Over the last 14 years we noted an increase in incidence and mortality in colon and rectal cancer. Crude incidence rate increased from 17.7 cases per 100, 000 to 24.3 for colon cancer and 11.3 to 12.8 for rectal cancer. The distribution of stages at presentation remained constant: 52.6% presented with stage I and II, 21.6% with stage III and 19.5% with stage IV disease for colon cancer and 63.2% with stage I and II, 15.1% with stage III and 15.1 with stage IV for rectal cancer. Despite the majority of patients presenting with early stage disease, 40.6% of colon cancer patients and 33.8% of rectal cancer patients died within a year of diagnosis. This number improved with the increased use of combined therapy in management of colorectalcancer. (Figure1).
A wide variety and number of cases were performed at the National Cancer Institute in Ukraine with similar distribution to Brigham and Women’s Hospital in 2013. 260 operations for colon and rectal cancer were performed at the National Cancer Institute and 268 at the Brigham and Women’s Hospital. Of them, 31% vs. 28% were hemicolectomies, 52% vs. 53% were anterior and low anterior resections, 12% vs. 13% were abdominoperineal resections respectively.
Conclusion Despite some improvement in colorectal cancer care and 1 year mortality in Ukraine the prognosis is still poor. It is perplexing that even though the large number of patients are diagnosed with early disease the outcomes are still poor. Since the incidence of colorectal cancer in increasing more studies are needed to establish the feasibility of colon cancer screening, to confirm the accurate reporting of stage distribution and to characterise barriers to obtain adequate care for colorectal cancer in Ukraine.
Disclosure of interest None Declared.
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