Socioeconomic Influence Rectal Cancer Treatment Rates

Only half of locally advanced rectal cancer patients receive standard therapy, which could in part be linked to socioeconomic factors, a recent study found.

The standard care over the past decade has been neoadjuvant chemoradiation therapy (NACRT) followed by surgery, which has shown the best outcomes.

A study published in Cancer gathered data from the National Cancer Data Base to identify 66,197 patients diagnosed and treated for stage 2 and 3 rectal adenocarcinoma between 2004 and 2012.

The results of the study showed that patients who received NACRT increased over the study time period, with 42.9% from 2004 to 2006; 50% from 2007 to 2009; and 55% from 2010 to 2012. Furthermore, less favorable treatments, including chemoradiation after surgery or surgery alone, declined.

Despite the increase, only about half of patients were currently receiving NACRT, a treatment recommended by national guidelines.

Some factors associated with the lack of NACRT treatment included receiving treatment at a facility with low or medium case volume; being of other than non-Hispanic white race/ethnicity; lack of private insurance; and residence in lower education neighborhoods.

“Unfortunately, with only 55% of US patients with locally advanced rectal cancer receiving the standard of treatment in the recent years, one must address the gap between the guidelines and the variable penetrance into routine clinical practice,” the study authors wrote.