Environmental factors of cancer of the colon and rectum. II. Japanese epidemiological data

Cancer of the colon in California, 1945-1966: the California Tumor Registry experience

Appropriate data from the California Tumor Registry (1945–1966) and the Alameda County Tumor Registry were analyzed with specific reference to colon cancer (excluding rectal cancer) I.C.D.A. No. 153. The high incidence of colon cancer in the Chinese population (33.8 per 100,000) requires further epidemiologic study to ascertain its significance. The sigmoid colon is the location of the highest percentage of colonic tumors. The 5‐year relative survival rate for all stages of colon cancer has increased from 24% in 1945 to 43.2% in 1966. For cases localized at the time of diagnosis, the 5‐year relative survival rate was 71.3%. An inverse relationship between age and survival was noted for both sexes, except for those under 45, who had a poorer survival experience. An appreciable difference was seen in the lessened survival of patients with upper colonic versus lower colonic lesions. Part of the increase in survival over time appeared to be due to an increasing percentage of patients who received surgery in contrast to other modalities. Part of the female's better survival experience was due to the fact that more women in proportion to men with colon cancer underwent surgery. The physician should take these characteristics, among others, into account when advising his patient on his chances of survival (and when considering treatment modality), and be alert to the high risk of this entity in certain racial, sex, and age groups as noted.