Trends in the Treatment of Metastatic Colon and Rectal Cancer in Elderly Patients

Datos Bibliográficos

ID9104969
AutoresCathy J Bradley (0000-0001-8586-8009, Department of Health Systems, Management, and Policy, Colorado Comprehensive Cancer Center, University of Colorado, Aurora, CO), K Robin Yabroff (0000-0003-0644-5572, Health Services and Economics Branch, National Cancer Institute, Bethesda), Joan L Warren (0000-0002-6467-6769, Health Services and Economics Branch, National Cancer Institute, Bethesda), Christopher Zeruto (Information Management Services, Rockville, MD), Christopher A Zeruto (Information Management Services), Neetu Chawla (0000-0003-3486-2023, Health Services and Economics Branch, National Cancer Institute, Bethesda), Elizabeth B Lamont (0000-0001-6604-678X, Departments of Medicine and Health Care Policy, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA)
Año2016
Volumen54
Número5
Páginas490-497
Fecha de publicación2016-05-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000510
PMID26900834
OpenAlexW2327047767
IdiomaEN
Citas recibidas2
Referencias citadas38

BACKGROUND: Little is known about the use and costs of antineoplastic regimens for elderly patients with metastatic colorectal cancer (mCRC). We report population-based trends over a 10-year period in the treatment, survival, and costs in mCRC patients, stratified by ages 65-74 and 75+. METHODS: We used Surveillance, Epidemiology, and End Results-Medicare data for persons diagnosed with metastatic colon (N=16117) or rectal cancer (N=4008) between 2000 and 2009. We estimated the adjusted percent of patients who received antineoplastic agents, by type, number, and their costs 12 months following diagnosis. We report the percent of patients who received 3 or more of commonly prescribed agents and estimate survival for the 24-month period following diagnosis by age and treatment. RESULTS: The percentage that received 3 or more agents increased from 3% to 73% in colon patients aged 65-74 and from 2% to 53% in patients 75+. Similar increases were observed in rectal patients. Average 1-year costs per patient in 2009 were $106,461 and $102,680 for colon and rectal cancers, respectively, reflecting an increase of 32% and 20%, for patients who received antineoplastic agents. Median survival increased by about 6 and 10 months, respectively, for colon and rectal patients aged 65-74 who received antineoplastic agents, but an improvement of only 1 month of median survival was observed for patients 75+. CONCLUSIONS: Expensive multiple agent regimens are increasingly used in older mCRC patients. For patients aged 64-75 years, these treatments may be associated with several months of additional life, but patients aged 75+ may incur considerable expense without any survival benefit

Cancer · Colorectal cancer · Population · Colorectal Cancer Treatments and Studies · Economic and Financial Impacts of Cancer · Epidemiology · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Surgery