Compared to the control group, older patients also experienced more complication rates and hospital deaths. They remained in the hospital longer, and had associated hospital costs that were $10,000 higher than younger patients in the study.
“With the increased emphasis on economics in healthcare, this is the low-hanging fruit,” said Dr. Michael Stamos, lead author of the study which posted Wednesday in JAMA Surgery.
Although it is reassuring that colon-cancer surgery deaths have decreased, including a 9% drop in mortality rates among patients over age 85, many system improvements are still needed to effectively treat the geriatric colon-cancer patient population, said Stamos, a specialist in colon and rectal surgery at the University of California, Irvine.
The study noted, for example, that postoperative complications remained significantly higher for the elderly, leading to higher costs, increased lengths of stay and decreased quality of life.
Findings were drawn from a nationwide sample taken from Jan. 1, 2001 through Dec. 31, 2010, which included an estimated 1,043,108 patients.
Still, the findings also showed that screening for colorectal cancers appears to have made a significantly positive difference.
There was a “noticeable trend towards decreasing cancer surgery” observed Dr. Konstantin Umanskiy, assistant professor of surgery with the University of Chicago Medicine, after reviewing the report. As a surgeon, he said that trend really spoke volumes. “It's very encouraging,” he said. “There is clearly a benefit of screening and the observation supports the notion that once you stop screening through colonoscopy at a certain age, the chance of detecting colon cancer is reduced.”
Another recent study found that during the past decade, colon-cancer incidence rates dropped by 30% in adults 50 and older, with the largest improvements seen in those older than age 65, the group most likely to die from the disease. Widespread increases in colonoscopy screening over the past 10 years contributed to lower incidence rates, according to that report.
Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States, according to the American Cancer Society. An estimated 96,830 new cases of colon cancer and 40,000 new cases of rectal cancer are anticipated in 2014.
