Epidemiology, disease progression, and economic burden of colorectal cancer

Abstract

BACKGROUND: Every 3.5 minutes, someone is diagnosed with colorectal cancer (CRC); every 9 minutes, someone dies from CRC; and every 5 seconds, someone who should be screened for CRC is not. The 5-year mortality for people diagnosed with CRC is approximately 40%; however, survival improves substantially if the cancer is diagnosed while still localized. OBJECTIVE: To track and review the rapid progress researchers have made in CRC. SUMMARY: Among patients who have CRC, approximately 50% will eventually develop liver metastases. The oncology field's significant advances in the last few years, especially in CRC, challenge clinicians and patients. Multiple facets of care intersect in CRC: medical management, pharmacy management, symptom management, case management, and patient advocacy. CRC develops over many years as environmental and genetic factors interact. The American Cancer Society recommends screening all men and women older than 50 years and those at high risk at an earlier age. In the past, patients presenting with the same stage of CRC were considered similar. The staging criteria of the American Joint Committee on Cancer recognizes that subsets of patients with varying survival statistics can be identified and that each patient requires a strategic approach. The U.S. Food and Drug Administration approval of irinotecan in 1996 and oxaliplatin in 2002 changed the landscape, and ultimately, the oral agent capecitabine and the biologies bevacizumab and cetuximab also significantly expanded treatment options. CONCLUSION: Clinicians must consider all available treatment options and regimen sequences across multiple lines of therapy, creating an early plan for each patient to extend survival while minimizing side effects. Copyright© 2007, Academy of Managed Care Pharmacy. All rights reserved.