UICC World Cancer Congress 2006

Objective: Randomized trials have demonstrated that adjuvant chemotherapy improves survival for patients with stage III colon cancer. In 1990, a Consensus Conference of the NIH strongly recommended adjuvant chemotherapy for stage III colon cancer patients without medical or psychosocial contraindications. This study examines the relationship between patient characteristics and the use of adjuvant chemotherapy in patients with stage III colon cancer. Methods: A retrospective cohort study using the Charleston Area Medical Center, WV Tumor Registry identified 257 patients with resected stage III colon cancer diagnosed between 1991 and 2003. Results: Sixty-nine percent of patients received adjuvant chemotherapy. Variables considered in the study included: sex, race, age, income, tumor primary site and differentiation, number of lymph nodes examined and number of lymph nodes positive, distance traveled (from zip code), marital status, insurance status. A logistic regression model reveal that age > 70 (odds ratio OR 4.5, CI 2.3-8.8), distance traveled > 30 miles (OR 2.3, CI 1.2-4.3), and patients who were unmarried (OR 2.5, CI 1.4-4.7) were significantly less likely to receive treatment. Conclusion: Clinicians should recognize the importance of social, demographic and cultural forces as well as biomedical factors in discussions and decisions regarding the treatment of early stage cancer.