Treatment of rectal cancer varies throughout Europe

What type of treatment a patient diagnosed with rectal cancer receives may be determined by the country where treatment is sought, according to a study conducted by the European Cancer Organisation (ECCO), whose findings were presented at its annual meeting held last week in Stockholm.

In Europe, colorectal cancer is the second most commonly diagnosed type of cancer and the second most common cause of cancer-related death. A study to assess treatment variety and short-term outcomes of rectal cancer patients, called the European Registration of Cancer Care (EURECCA) study, evaluated 6,597 patients registered in a combined population-based dataset from Norway, Sweden, Denmark, and the Netherlands.

Enrollment included patients diagnosed with rectal cancer who underwent surgical treatment in 2008 and/or 2009. Differences in age, gender, stage at diagnosis, and the use of radiotherapy, chemotherapy, or both were compared between the countries. Treatments administered also were compared according to cancer stage within the countries.

The use of radiotherapy, chemotherapy, or a combined therapy was lowest in Denmark at 25%, followed by Norway at 50.3%, Sweden at 60.7%, and the Netherlands at 81.2%. Patients in the Netherlands were slightly younger than those of other countries, according to session presenter Dr. Colette van den Broek, a research fellow in surgery at Leiden University Medical Center in the Netherlands.

Researchers determined that treatment with any of these therapies varied depending upon the stage of the disease in each country. In Norway, patients with stage IV disease received one of the treatments most often, whereas in Sweden, patients with stage II or III disease received it the most. In contrast, patients with stage I to III disease received a treatment the most often in Denmark and the Netherlands.

In the Netherlands, radiotherapy is used for almost all stages of cancer, while in Denmark, a combination of radiotherapy and chemotherapy is used, according to Van den Broek. The study may be the first step to development of a single guideline that can be used throughout Europe, she said.

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