The burden of colorectal cancer: prevention, treatment and quality of services

Excerpt

Colorectal cancer (CRC) is one of the most common forms of cancer and is a substantial health burden in most developed countries, with high incidence and mortality in combination with moderate survival. It is often diagnosed late due to the absence of screening programmes, lack of knowledge about symptoms and/or a reluctance to seek medical help once the symptoms have appeared. Although improvements in outcomes over time have been made, compared with other high incidence cancers, such as breast cancer, overall survival for CRC remains relatively poor. However, early detection is feasible and for patients with early disease, surgery alone can be curative. Chemotherapy is essential to provide a chance of cure for patients with more advanced disease and during the past 10 years, a number of new agents have been introduced, with a subsequent increase in life expectancy for patients with Stage-IV disease from 5 to over 20 months. However, facilities for treatment, use of and adherence to clinical management guidelines and access to new, effective treatments reportedly vary widely across OECD countries. Cancer spending on CRC is difficult to disaggregate, but evidence suggests that treatment costs are high, particularly for Stage III or IV which are advanced stages of the disease. Most countries also appear to have, for the most part, little concerted effort with regards to screening activities. Similarly, both public and political interest in CRC activities appears minimal to non-existent in some countries compared to the public/media profile of breast cancer, for example. …