Age disparities in stage-specific colon cancer survival across seven countries: an ICBP SURVMARK-2 population-based study

We sought to understand the role of stage at diagnosis in observed age disparities in colon cancer survival among people aged 50-99 using population-based cancer registry data from seven high-income countries: Australia, Canada, Denmark, Ireland, New Zealand, Norway and the United Kingdom. We used colon cancer incidence data for the period 2010-2014. We estimated the three-year net survival, as well as the three-year net survival conditional on surviving at least six months and one year after diagnosis, by country and stage at diagnosis (categorised as localised, regional or distant) using flexible parametric excess hazard regression models. In all countries, increasing age was associated with lower net survival. For example, three-year net survival (95% confidence interval) was 81% (80 to 82) for 50-64 year olds and 58% (56 to 60) for 85-99 year olds in Australia, and 74% (73 to 74) and 39% (39 to 40) in the United Kingdom, respectively. Those with distant stage colon cancer had the largest difference in colon cancer survival between the youngest and the oldest patients. Excess mortality for the oldest patients with localised or regional cancers was observed during the first six months after diagnosis. Older patients diagnosed with localised (and in some countries regional) stage colon cancer who survived six months after diagnosis experienced the same survival as their younger counterparts. Further studies examining other prognostic clinical factors such as comorbidities and treatment, and socioeconomic factors are warranted to gain further understanding of the age disparities in colon cancer survival. This article is protected by copyright. All rights reserved.