Estimating the number of colorectal cancer patients treated with anti-tumour therapy in 2015: the analysis of the Czech National Cancer Registry

Abstract

BackgroundColorectal cancer (CRC) represents a serious health care problem in the Czech Republic, introducing a need for a prospective modelling of the incidence and prevalence rates. The prevalence of patients requiring anti-tumour therapy is also of great importance, as it is directly associated with planning of health care resources.MethodsThis work proposes a population-based model for the estimation of stage-specific prevalence of CRC patients who will require active anti-tumour therapy in a given year. Its applicability is documented on records of the Czech National Cancer Registry (CNCR), which is used to estimate the number of patients potentially treated with anti-tumour therapy in the Czech Republic in 2015.ResultsSeveral scenarios are adopted to cover the plausible development of the incidence and survival rates, and the probability of an anti-tumour therapy initiation. Based on the scenarios, the model predicts an increase in CRC prevalence from 13% to 30% in comparison with the situation in 2008. Moreover, the model predicts that 10,074 to 11,440 CRC patients will be indicated for anti-tumour therapy in the Czech Republic in 2015. Considering all patients with terminal cancer recurrence and all patients primarily diagnosed in stage IV, it is predicted that 3,485 to 4,469 CRC patients will be treated for the metastatic disease in 2015, which accounts for more than one third (34-40%) of all CRC patients treated this year.ConclusionsA new model for the estimation of the number of CRC patients requiring active anti-tumour therapy is proposed in this paper. The model respects the clinical stage as the primary stratification factor and utilizes solely the population-based cancer registry data. Thus, no specific hospital data records are needed in the proposed approach. Regarding the short-term prediction of the CRC burden in the Czech Republic, the model confirms a continuous increase in the burden that must be accounted for in the future planning of health care in the Czech Republic.

Estimating Cancer Incidence, Prevalence, and the Number of Cancer Patients Treated with Anti-tumor Th erapy in 2015 and 2020 – Analysis of the Czech National Cancer Registry

“…In colorectal cancer, for example, we feel that the most likely scenario for the forthcoming years is the one with improving survival rates [10]; however, the stage-specific trends in incidence are not uniform. The incidence of stage I colorectal cancer is increasing due to earlier detection within colorectal cancer screening, where uptake of the screening program has substantially for long-term survival (e. g. Hodgkin disease, cancer of testis, etc).…”

“…The concept of estimation comes from the model of time interval prevalence, a number of patients who both have a present or past dia gnosis of cancer and are alive in a population during a certain period. Detailed description of the model was published elsewhere [10]. Regarding one age group, the stage-specific prevalence in calendar year y can be expressed as the convolution of the stage-specific incidence at i years prior to the calendar year y and the corresponding i-year survival rate.…”

“…Data of the Czech National Cancer Registry (CNCR), which was established in 1976 as a nationwide registry (10,230,000 inhabitants according to the 2001 census), was used for the analysis. Until the end of 2011, there were more than 1.9 million cancer cases recorded in the CNCR.…”

“…The disease extent should be also taken into account in the model as the clinical stage is, regarding patient life-expectation and anticipated fi nancial costs, even more important than age [8]. However, the eff ort to estimate cancer prevalence on a stage-specific basis is a challenging task [9,10]. The stage-specific modelling is complicated and requires a comprehensive approach, since the stage at the time of dia gnosis need not necessarily coincide with the disease extent several years afterwards.…”

“…Statistical model utilizing solely the population-based cancer registry data was used for this purpose [10]. The estimated numbers of probably treated patients are given with respect to individual phases of the anti-tumor therapy -the number of newly dia gnosed and treated patients, the number of patients treated for non-terminal cancer recurrence and the number of patients treated for terminal cancer recurrence.…”