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Colorectal Cancer: Incidence and Mortality among The Medicare Population (1990-1997)

Islam, K.M. Monirul
http://rave.ohiolink.edu/etdc/view?acc_num=case1093980347

Abstract Details

2005, Doctor of Philosophy, Case Western Reserve University, Epidemiology and Biostatistics.
Background: Population-based studies of colorectal cancer incidence and mortality of Medicare beneficiaries 65 and older are limited. The Surveillance, Epidemiology and End Results data provided estimates based on 12% of the U.S. population. A few studies addressed 30-day post operative mortality. The results of these studies are conflicting. Methods: 100% of Medicare beneficiaries 65 years or older with a first known diagnosis of colorectal cancer from 1990-1997 were studied. We utilized a cross-sectional study design to study incidence and mortality rates and a longitudinal study design to examine 30-day survival rates. Tumor site was divided into rectum, distal colon and proximal colon. The analysis was stratified by age-group, race, sex, presence or absence of metastatic disease and site of origin. Results: The incidence rates for colon cancer were 193.77 patients’ age 65-69 years in 1990-1991 and 184.17/100,000 in 1996-1997. The incidence rates for colon cancer patients 85 years and older were 349.89 and 458.43/100,000 in 1990-1991 and 1996-1997. Right-sided colon cancer incidence rates were 141.65 and 170.04/100,000 and left-sided colon cancer rates were 123.98 and 120.84 in 1990-1991 and 1996-1997. The rectal cancer incidence rates were much lower than colon cancer incidence rates. The incidence trend with age persisted with all three sites of colorectal cancer. Age-adjusted incidence rates for colon cancer were 306.66 and 325.90 and for rectal cancer were 38.03 and 41.11 per 100,000 in 1990-1991 and 1996-1997. Left-side colon cancer patients had the highest 30-day post operative mortality (7.68/100 in 1990-1991 and 8.73/100 in 1996-1997) among the three sites of the tumors. Conclusions: The study populations are getting older. More colon cancer as opposed to rectum cancer cases were found in blacks, women and younger patients. Colorectal cancer incidence rates increased during 1990-1997 but there was a decreased trend of left-side colon cancer. There is a substantial variation in colorectal cancer incidence among states. 30-day mortality rates of colon cancer increased and rectal cancer decreased during the study period.
Alfred Rimm, Ph.D. (Advisor)
Health Sciences, Public Health
Colorectal; cancer; incidence; mortality and medicare

Recommended Citations

Citations

  • Islam, K.M. M. (2005). Colorectal Cancer: Incidence and Mortality among The Medicare Population (1990-1997) [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1093980347

    APA Style (7th edition)

  • Islam, K.M.. Colorectal Cancer: Incidence and Mortality among The Medicare Population (1990-1997). 2005. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1093980347.

    MLA Style (8th edition)

  • Islam, K.M.. "Colorectal Cancer: Incidence and Mortality among The Medicare Population (1990-1997)." Doctoral dissertation, Case Western Reserve University, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=case1093980347

    Chicago Manual of Style (17th edition)

case1093980347
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© 2004, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.