From the Guidelines
The incidence of Stage 4 (T4) colon cancer in the United States is not directly stated in the provided evidence, but we can estimate that around 20-25% of the 105,000 new cases of colon cancer diagnosed in 2021 may be Stage IV, which translates to approximately 21,000-26,250 cases per year. According to the study published in the Journal of the National Comprehensive Cancer Network 1, the incidence of colon and rectal cancers per 100,000 people has been decreasing over the years, with a decrease of 3.3% annually between 2011 and 2016 in those aged 65 years or older. However, the incidence has increased among those younger than 65 years, with a 1% annual increase in those aged 50 to 64 years and a 2% annual increase in those younger than 50 years. Some key points to consider include:
- The 5-year survival rate for Stage IV colon cancer is approximately 14% 1, though this varies based on the extent of metastasis, patient age, overall health, and response to treatment.
- Treatment typically involves systemic chemotherapy regimens such as FOLFOX or FOLFIRI, often combined with targeted therapies like bevacizumab or cetuximab depending on the tumor's molecular profile 1.
- Early detection through regular screening colonoscopies beginning at age 45 for average-risk individuals remains the most effective strategy for preventing advanced-stage diagnoses 1. It's essential to note that the provided evidence does not directly address the incidence of Stage 4 (T4) colon cancer, but rather Stage IV colon cancer, which refers to the spread of cancer beyond the colon to distant organs. However, based on the available data, we can make an educated estimate of the incidence of Stage IV colon cancer.
From the Research
Incidence of Stage 4 (T4) Colon Cancer in the US
- The incidence of Stage 4 (T4) colon cancer in the US is not directly stated in the provided studies 2, 3, 4, 5, 6.
- However, study 3 mentions that in the southwestern part of the Netherlands, 18% of new patients with colorectal cancer were diagnosed with synchronous metastatic disease, which increased to 21% over the study period.
- Study 5 reports that in an equal-access health care system, 25% of patients presented with stage III disease, and compared to patients aged 50 to 79 and ≥80 years, patients aged <40 and 40 to 49 years presented more frequently with advanced disease (stage III and stage IV) 5.
- Study 6 examined the incidence rates of early- and late-onset colorectal cancer in the US, but does not specifically report on the incidence of Stage 4 (T4) colon cancer 6.
- Study 4 focuses on high-risk stage II colon cancer and reports that adjuvant chemotherapy is associated with improved overall survival only among patients with T4 as the single high-risk feature or combinations involving T4 4.
Stage 4 Colon Cancer Incidence by Age and Race
- Study 5 found that patients aged <40 and 40 to 49 years presented more frequently with advanced disease (stage III and stage IV) compared to older patients 5.
- Study 6 reports that early-onset CRC rates are higher in American Indians/Alaskan Natives and Blacks compared to Whites, and late-onset CRC rates remain higher in Blacks and American Indians/Alaskan Natives compared to Whites 6.