Recent decline in risk for colorectal cancer recurrence seen in stage I to III disease

From 2004 to 2019, the risk for recurrence of colorectal cancer (CRC) decreased in patients with stages I to III disease, according to a study published online Nov. 16 in JAMA Oncology to coincide with the annual meeting of the Danish Surgical Society, held from Nov. 16 to 17 in Copenhagen.

Jesper Nors, M.D., from Aarhus University Hospital in Denmark, and colleagues examined the rates of recurrence and time to recurrence within five years of surgery with curative intent in a cohort of 34,166 patients with Union for International Cancer Control (UICC) stages I to III CRC who underwent primary surgery from Jan. 1, 2004, to Dec. 31, 2019. The association between the calendar period of primary surgery (2004 to 2008, 2009 to 2013, and 2014 to 2019) and recurrence risk was examined.

The researchers found that 7,027 participants developed recurrence within five years after the primary surgery. During the three calendar periods, the five-year cumulative incidence function of recurrence decreased from 16.3 to 6.8 percent, 21.9 to 11.6 percent, and 35.3 to 24.6 percent for UICC stage I, II, and III colon cancer, respectively.

The corresponding decreases for rectal cancer were from 19.9 to 9.5 percent, 25.8 to 18.4 percent, and 38.7 to 28.8 percent. Compared with those with stage I disease, patients with stage III disease had a shorter time from surgery to recurrence. Lower stage-adjusted risks for recurrence were seen for cancers detected versus not detected through screening (subdistribution hazard ratio, 0.81).

"We believe that the risk of CRC recurrence has become so low in selected patient groups that further research on personalized surveillance protocols is indicated," the authors write.

One author disclosed ties to industry.

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