Many people with colon cancer do not get recommended therapy

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In a new study, researchers found that many patients with colon cancer are not receiving the recommended standard of care therapy for their disease.

The research was conducted by a team at the University of Kentucky Markey Cancer Center.

Though the state has made great advances in colorectal cancer screening the past two decades, Kentucky continues to rank fifth in the nation for colorectal cancer mortality.

Locally advanced colon cancers (LACC) – defined as colon cancers with high-risk microscopic features or that have begun spreading via lymph nodes—are best treated with multiple modalities.

The National Comprehensive Cancer Network practice guidelines recommend surgical removal of the tumor followed by adjuvant chemotherapy for stage IIb, IIc, and stage III colon cancers, which has greatly improved the survival of these patients.

The study examined data for 1,404 Kentucky patients with LACC, gathered from the Kentucky Cancer Registry and insurance billing codes.

Results showed that nearly 42% of these patients did not receive the full standard of care therapy, with the vast majority of patients failing to receive their adjuvant chemotherapy following surgery.

Among patients who did receive standard of care for colon cancer, the survival rate was 63%; for those who did not comply with a standard of care, the survival rate dropped to 27%.

Several risk factors were identified for those who did not receive standard of care, including patients age 65 and older, a high comorbidity index (i.e., other serious health issues), disability, Medicaid insurance status, and a moderate to the high poverty level.

The team says the study highlights the importance of adherence to the standard of care for these patients.

Many of these characteristics are shared by our Appalachian patient population, which is a vulnerable population here in Kentucky.

With this knowledge, the UK Markey Cancer Center and its Affiliate Network are working on measures that will help increase access to a standard of care therapies to this vulnerable population.

The lead author of the study is Dr. Avinash Bhakta, a colorectal cancer surgeon with the UK Markey Cancer Center.

The study is published in the Journal of the American College of Surgeons.

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