Colorectal Cancer Statistics From the Veterans Affairs Central Cancer Registry

Abstract

Background: 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 and methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Colorectal; Incidence; Mortality; Neoplasms; U.S. Department of Veterans Affairs.

Conflict of interest statement

The authors report no conflicts of interest in this work. Dr. Zullig is support by a Veterans Affairs Health Services Research & Development Career Development Award (CDA 13-025). Drs. Bosworth (RCS 08-027) and Weinberger (RCS 91-408) are supported by Senior Research Career Scientist awards from VA Health Services Research & Development. This content is solely the responsibility of the authors and does not reflect the position or policy of the U.S. Department of Veterans Affairs of the United States Government.

Published by Elsevier Inc.

Figures

Figure 1

Cohort Assembly Diagram

Figure 2

Distribution of Colorectal Tumor Location by Age and Sex, 2009 to 2012.

Figure 3. Kaplan Meier Survival Curves by Age

Note: Patients diagnosed later in the study time period did not have a full five years of observation. Thus, this figure depicts 3-year survival data and is censored for those patients without sufficient follow-up time.

Figure 4. Kaplan Meier Survival Curves by Stage

Note: Patients diagnosed later in the study time period did not have a full five years of observation. Thus, this figure depicts 3-year survival data and is censored for those patients without sufficient follow-up time.