Descriptive Analysis of Colorectal Cancer in Appalachia

Colorectal cancer, which includes cancers of both the colon and the rectum, is the second-leading cause of cancer-related deaths in the United States. In women, it ranks third after lung and breast cancer, and in men, it ranks third after lung and prostate cancer. Incidence and mortality are similar in both men and women. In 2001, an estimated 135,400 Americans were diagnosed with colorectal cancer and an estimated 56,700 deaths occurred in the United States. There are effective treatments for colorectal cancer. The most common treatment is surgical resection. Usually this involves the removal of the primary tumor, part of the healthy colon or rectum, and nearby lymph nodes. The one-year survival rate for colorectal cancer is 82%. The five-year survival rate is 61%. When the cancer is detected very early the 5-year survival rate climbs to 91%, but less than 40% of colorectal cancers are discovered at this stage. The purpose of this study is to conduct a population-based descriptive analysis of the current state of colorectal cancer treatment among recipients of Medicare in a) West Virginia, b) Appalachia, c) rural non-Appalachian areas, d) poor urban regions, and e) the United States in general to examine treatment patterns by region. Regional Medicare medical and prescription claims will be analyzed to estimate rates of colorectal cancer medication usage and medical resource utilization for the abovementioned regions. This descriptive analysis, which will provide a baseline assessment of the treatment patterns of colorectal cancer, will begin to examine the question of whether disparities in rates of mortality and/or survival from colorectal cancer can be explained by variations in treatment. This study will serve as a preliminary work for studies that investigate why variations in treatment by geographic region, and sociodemographics such as age, gender, and ethnicity exist. Results from this study can also identify topics for future empirical analyses that coincide with colorectal cancerrelated public policy initiatives in the state of West Virginia and the region of Appalachia.