Population-based survival from colorectal cancer in Mumbai, (Bombay) India

Survival estimates of patients registered by population-based cancer regist ries reflect the average prognosis from a given cancer as they are based on unselected patients with a wide range of natural histories and treatment p atterns. In this paper, we report the survival experience of colorectal can cer patients in Mumbai (Bombay), India. Follow-up information an 1642 color ectal cancer patients registered by the Bombay Population-based Cancer Regi stry for the period 1987-1991 was obtained by matching with death certifica tes from the Bombay vital statistics registration system, postal/telephone enquiries, home visits and scrutiny of medical records, Cumulative observed and relative survival proportions were calculated by Hakulinen's method. F or comparison of results with other populations, age-standardised relative survival (ASRS) was calculated by directly standardising age-specific relat ive survival to the specific age distributions of the world standard cancer patient population in 1985. The log-rank test was used to identify the pot ential prognostic variables which were introduced step-wise into a Cox regr ession model to identify the independent predictors of survival. The 5-year relative survival was 36.6% for colon and 42.2% for rectal cancer. Age, si te of cancer and clinical stage of disease emerged as independent predictor s of survival. Age-specific 5-year relative survival declined with advancin g age. Survival at 5 years was 61.2% for localised colon cancer; 31.9% For regional and 9.0% for distant metastatic disease. These were 65.7, 25.6 and 4.3%, respectively for rectal cancers. Comparison of the results with othe r populations revealed significant variations, which seem to be related to differences in detection and treatment. The prognosis from colorectal cance r in Mumbai and developing countries, may be further improved through early detection linked with treatment. (C) 2001 Elsevier Science Ltd. All rights reserved.