Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 8;15(18):4474.
doi: 10.3390/cancers15184474.

Colorectal Cancer Survival in German-Danish Border Regions-A Registry-Based Cohort Study

Christiane Rudolph  1 , Gerda Engholm  2 , Ron Pritzkuleit  1 , Hans H Storm  2 , Alexander Katalinic  1
Affiliations

Colorectal Cancer Survival in German-Danish Border Regions-A Registry-Based Cohort Study

Christiane Rudolph et al. Cancers (Basel). .

Abstract

The aim of this study was (i) to update the reporting of colorectal cancer survival differences over time in the German-Danish border region (Schleswig-Holstein, Southern Denmark, and Zealand) and (ii) to assess the extent to which it can be explained by stage and primary treatment. Incident invasive colorectal cancer cases diagnosed from 2004 to 2016 with a follow-up of vital status through 31 December 2017 were extracted from cancer registries. Analyses were conducted by anatomical subsite and for four consecutive periods. Kaplan-Meier curves and log-rank tests were computed. Cox regression models using data from Schleswig-Holstein from 2004 to 2007 as the reference category were run while controlling for age, sex, stage, and treatment. The cox regression models showed decreasing hazard ratios of death for all three regions over time for both anatomical subsites. The improvement was stronger in the Danish regions, and adjustment for age, sex, stage, and treatment attenuated the results only slightly. In 2014-2016, colon cancer survival was similar across regions, while rectal cancer survival was significantly superior in the Danish regions. Regional survival differences can only partially be explained by differing stage distribution and treatment and may be linked additionally to healthcare system reforms and screening efforts.

Keywords: Kaplan–Meier estimate; benchmarking; chemotherapy; colorectal neoplasm; health care quality; neoplasm staging; proportional hazard models; radiotherapy; surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Stage distribution of the included colon and rectal cancer patients for the regions of Schleswig-Holstein, Southern Denmark, and Zealand in 2004–2016.
Figure 2
Figure 2
Cancer treatment stratified by stage for colon and rectal cancer in the project regions, 2004–2016.
Figure 3
Figure 3
(a) Kaplan–Meier curves depicting the colon cancer survival in Schleswig-Holstein, Southern Denmark, and Zealand stratified by period of diagnosis. (b) Kaplan–Meier curves depicting the rectal cancer survival in Schleswig-Holstein, Southern Denmark, and Zealand stratified by period of diagnosis.
Figure 3
Figure 3
(a) Kaplan–Meier curves depicting the colon cancer survival in Schleswig-Holstein, Southern Denmark, and Zealand stratified by period of diagnosis. (b) Kaplan–Meier curves depicting the rectal cancer survival in Schleswig-Holstein, Southern Denmark, and Zealand stratified by period of diagnosis.
Figure 4
Figure 4
Crude (C) and fully adjusted (A) hazard ratios of death for colon cancer and rectal cancer in Schleswig-Holstein, Southern Denmark, and Zealand compared to cases diagnosed in 2004–2007 in Schleswig-Holstein.
See this image and copyright information in PMC

References

    1. Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J. Clin. 2021;71:209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Cardoso R., Guo F., Heisser T., Hackl M., Ihle P., De Schutter H., Van Damme N., Valerianova Z., Atanasov T., Májek O., et al. Colorectal cancer incidence, mortality, and stage distribution in European countries in the colorectal cancer screening era: An international population-based study. Lancet Oncol. 2021;22:1002–1013. doi: 10.1016/S1470-2045(21)00199-6. - DOI - PubMed
    1. Allemani C., Matsuda T., Di Carlo V., Harewood R., Matz M., Nikšić M., Bonaventure A., Valkov M., Johnson C.J., Estève J., et al. Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): Analysis of individual records for 37,513,025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391:1023–1075. doi: 10.1016/S0140-6736(17)33326-3. - DOI - PMC - PubMed
    1. Lundberg F.E., Birgisson H., Johannesen T.B., Engholm G., Virtanen A., Pettersson D., Ólafsdóttir E.J., Lambe M., Lambert P.C., Mørch L.S., et al. Survival trends in patients diagnosed with colon and rectal cancer in the Nordic countries 1990–2016: The NORDCAN survival studies. Eur. J. Cancer. 2022;172:76–84. doi: 10.1016/j.ejca.2022.05.032. - DOI - PubMed
    1. Araghi M., Arnold M., Rutherford M.J., Guren M.G., Cabasag C.J., Bardot A., Ferlay J., Tervonen H., Shack L., Woods R.R., et al. Colon and rectal cancer survival in seven high-income countries 2010–2014: Variation by age and stage at diagnosis (the ICBP SURVMARK-2 project) Gut. 2021;70:114–126. doi: 10.1136/gutjnl-2020-320625. - DOI - PubMed

LinkOut - more resources