The timing between the diagnosis and the end of the last treatment in the cancer continuum in patients with colon cancer by TNM stages; and the impact of delays in the final survival of the patients, in PLCO, In the period available in the data set.
Principal Investigator
Name
Percy Guzman
Degrees
MD MSc
Institution
Percy Guzman
Position Title
NCI Fellow
Email
About this CDAS Project
Study
PLCO
(Learn more about this study)
Project ID
PLCO-882
Initial CDAS Request Approval
Jan 7, 2022
Title
The timing between the diagnosis and the end of the last treatment in the cancer continuum in patients with colon cancer by TNM stages; and the impact of delays in the final survival of the patients, in PLCO, In the period available in the data set.
Summary
CRC is in the top five for incidence and mortality in US statistics, and it is also in the top five most expensive to treat.
This tumor has in its actions a wide number of screening options such as stool tests, colo or sigmoidoscopy, tomography and even barium, all with adequate sensitivity. A timely diagnosis, in asymptomatic or screened patients, allows a better prognosis, with greater and more effective therapeutic options, reflected in an increase in life expectancy.
The available literature only shows recommendations on when it is better to start, some studies show an increased risk between diagnosis and until surgery, and many others between surgery and chemotherapy, and the effect of each (separately) on overall survival, but none of them show significant differences; some studies analyze whether any delay in the continuum after diagnosis modifies final survival.
It is important to describe what is happening now with health care. Today, we have many screening tests and therapies around the world that allow patients to live long-term after cancer. But with the barriers that are raised in the health system, from the symptom to the first access to care and finally throughout the treatment, our main task as researchers must be to describe what is happening. After describing the factors involved in care, along the continuum, and how these may or may not affect the success of the treatments and the results, the evaluation of the results could be qualitative (quality of life, side effects, etc.) or quantitative. (survival, relapse, or recurrence, etc.).
CRC is a cancer with a 5-year survival rate of around 65%, with these percentages we could easily see any change in survival if we make a subtle change (intervention) anywhere on the continuum.
The morbidities associated with an early diagnosis are lower, with faster rehabilitation and social reintegration, which reduces the cost of man-hours in the country's productive sector. Treatment "on time" allows patients to reduce the likelihood of relapses or recurrences in the long term.
Why start with CRC, because this in the entire range of existing cancers, is one of the simplest within the cancer continuum, and in most cases only surgery and chemotherapy are needed, radiation therapy only in some cases or in cases advanced; and general therapy regimens have little variability.
The feasibility of this study is high, because to demonstrate the theory or the hypothesis we do not need a high budget, we need a set of available data with some described variables. It is less complex if we divide the cancer continuum into two stages (before / after diagnosis), the higher proportion of budget could be necessary at the moment when we are going to do the study in the first step, before diagnosis.
This tumor has in its actions a wide number of screening options such as stool tests, colo or sigmoidoscopy, tomography and even barium, all with adequate sensitivity. A timely diagnosis, in asymptomatic or screened patients, allows a better prognosis, with greater and more effective therapeutic options, reflected in an increase in life expectancy.
The available literature only shows recommendations on when it is better to start, some studies show an increased risk between diagnosis and until surgery, and many others between surgery and chemotherapy, and the effect of each (separately) on overall survival, but none of them show significant differences; some studies analyze whether any delay in the continuum after diagnosis modifies final survival.
It is important to describe what is happening now with health care. Today, we have many screening tests and therapies around the world that allow patients to live long-term after cancer. But with the barriers that are raised in the health system, from the symptom to the first access to care and finally throughout the treatment, our main task as researchers must be to describe what is happening. After describing the factors involved in care, along the continuum, and how these may or may not affect the success of the treatments and the results, the evaluation of the results could be qualitative (quality of life, side effects, etc.) or quantitative. (survival, relapse, or recurrence, etc.).
CRC is a cancer with a 5-year survival rate of around 65%, with these percentages we could easily see any change in survival if we make a subtle change (intervention) anywhere on the continuum.
The morbidities associated with an early diagnosis are lower, with faster rehabilitation and social reintegration, which reduces the cost of man-hours in the country's productive sector. Treatment "on time" allows patients to reduce the likelihood of relapses or recurrences in the long term.
Why start with CRC, because this in the entire range of existing cancers, is one of the simplest within the cancer continuum, and in most cases only surgery and chemotherapy are needed, radiation therapy only in some cases or in cases advanced; and general therapy regimens have little variability.
The feasibility of this study is high, because to demonstrate the theory or the hypothesis we do not need a high budget, we need a set of available data with some described variables. It is less complex if we divide the cancer continuum into two stages (before / after diagnosis), the higher proportion of budget could be necessary at the moment when we are going to do the study in the first step, before diagnosis.
Aims
General aim:
o Describe the timing between the diagnosis and the end of the last treatment in the cancer continuum in patients with colon cancer by TNM stages, and the impact of delays in the final survival of the patients
Specific aims:
o Observe the general characteristics in patients with colorectal cancer.
o Describe the time of each treatment process, during and after diagnosis of CRC.
o Identify the factors that intervene throughout the continuum of cancer and produce delays in the screening, diagnosis, and treatment pathway.
o Analyze the survival of CRC patients by TNM stages.
o Describe at what point (number of weeks after diagnosis) we do or do not observe delays in the CRC continuum.
Collaborators
Percy Guzman Montero, CPFP fellow, DCCPS, HARB,
Michael Halpern, DCCPS, HARB, medical officer.