Comorbidity and survival of Danish patients with colon and rectal cancer from 2000–2011: a population-based cohort study

Figures & data

Table 1 Characteristics of colon and rectal cancer patients in the Central Region of Denmark 2000–2011

Characteristics	Year of diagnosis				Total
	2000–2002	2003–2005	2006–2008	2009–2011
Colon cancer
Sex
Male (%)	629 (49)	616 (46)	759 (50)	790 (49)	2794 (48)
Female (%)	663 (51)	731 (54)	769 (50)	820 (51)	2983 (52)
Median age (years)	72	73	73	72
Comorbidity
Charlson score 0 (%)	856 (66)	841 (62)	894 (59)	992 (62)	3583 (62)
Charlson score 1–2 (%)	362 (28)	391 (29)	475 (31)	451 (28)	1679 (29)
Charlson score 3+ (%)	74 (6)	115 (9)	159 (10)	167 (10)	515 (9)
Median age (years)
Charlson score 0 (%)	71	70	69	69
Charlson score 1–2 (%)	75	75	76	76
Charlson score 3+ (%)	74	78	77	78
Rectal cancer
Sex
Male (%)	388 (54)	380 (60)	435 (57)	468 (55)	1671 (56)
Female (%)	328 (46)	255 (40)	325 (43)	385 (45)	1293 (44)
Median age (years)	70	69	68	69
Comorbidity
Charlson score 0 (%)	512 (72)	427 (67)	499 (66)	567 (66)	2005 (68)
Charlson score 1–2 (%)	163 (23)	167 (26)	194 (26)	221 (26)	745 (25)
Charlson score 3+ (%)	41 (6)	41 (6)	67 (9)	65 (8)	214 (7)
Median age (years)
Charlson score 0 (%)	68	67	64	67
Charlson score 1–2 (%)	74	74	74	73
Charlson score 3+ (%)	76	74	74	77

Table 2 Overall survival and mortality rate ratios after colon and rectal cancer according to diagnostic calendar periods in the Central Region of Denmark 2000–2011

	Year of diagnosis			2009–2011
	2000–2002	2003–2005	2006–2008
Colon cancer
Number of patients	1292	1347	1528	1610
1-year
Survival	68% (65%–70%)	70% (67%–72%)	71% (69%–73%)	73% (71%–75%)
MRR crude	1 (reference)	0.95 (0.83–1.08)	0.87 (0.76–1.00)	0.81 (0.71–0.93)
MRR adjusteda	1 (reference)	0.87 (0.76–0.99)	0.79 (0.69–0.91)	0.74 (0.64–0.85)
5-year
Survival	39% (37%–42%)	44% (41%–47%)	45% (43%–48%)b	46% (43%–48%)b
MRR crude	1 (reference)	0.89 (0.80–0.98)	0.86 (0.78–0.95)b	0.83 (0.76–0.92)b
MRR adjusteda	1 (reference)	0.83 (0.75–0.92)	0.79 (0.72–0.87)b	0.76 (0.69–0.84)b
Rectal cancer
Number of patients	716	635	760	853
1-year
Survival	77% (74%–80%)	77% (73%–80%)	80% (77%–82%)	82% (79%–85%)
MRR crude	1 (reference)	1.03 (0.83–1.29)	0.87 (0.70–1.09)	0.76 (0.61–0.96)
MRR adjusteda	1 (reference)	1.02 (0.82–1.28)	0.85 (0.68–1.05)	0.70 (0.56–0.88)
5-year
Survival	46% (42%–50%)	50% (46%–54%)	49% (45%–52%)b	51% (48%–55%)b
MRR crude	1 (reference)	0.92 (0.79–1.06)	0.92 (0.80–1.06)b	0.84 (0.73–0.97)b
MRR adjusteda	1 (reference)	0.90 (0.77–1.04)	0.91 (0.79–1.05)b	0.80 (0.70–0.93)b

Notes: Figures in brackets represent 95% confidence intervals;

a MRRs in different calendar periods using 2000–2002 as reference, adjusted for changes over time in age, sex, and comorbidity;

b predicted values.

Abbreviation: MMR, mortality rate ratio.

Figure 1 Kaplan–Meier curves for colon cancer patients in the Central Region of Denmark for four diagnostic periods for (A) Charlson score = 0, (B) Charlson score = 1–2, and (C) Charlson score = 3+.

Table 3 One-year and 5-year survival and relative mortality after colon cancer according to comorbidity level for each diagnostic period in the Central Region of Denmark 2000–2011

	Charlson score
	0	1–2	3+
2000–2002
Number of patients	856	362	74
1-year
Survival (%)	72% (69%–75%)	63% (58%–68%)	43% (32%–54%)
MRR crude	1 (reference)	1.41 (1.14–1.75)	2.71 (1.95–3.76)
MRR adjusteda	1 (reference)	1.19 (0.96–1.47)	2.19 (1.57–3.05)
5-year
Survival (%)	44% (41%–47%)	33% (29%–38%)	15% (8%–24%)
MRR crude	1 (reference)	1.34 (1.15–1.56)	2.46 (1.89–3.20)
MRR adjusteda	1 (reference)	1.20 (1.02–1.40)	2.10 (1.61–2.74)
2003–2005
Number of patients	841	391	115
1-year
Survival (%)	73% (70%–76%)	66% (62%–71%)	55% (45%–63%)
MRR crude	1 (reference)	1.32 (1.06–1.63)	1.93 (1.43–2.60)
MRR adjusteda	1 (reference)	1.17 (0.94–1.46)	1.61 (1.19–2.19)
5-year
Survival (%)	48% (45%–51%)	41% (36%–45%)	28% (20%–36%)
MRR crude	1 (reference)	1.23 (1.05–1.44)	1.79 (1.41–2.26)
MRR adjusteda	1 (reference)	1.11 (0.95–1.31)	1.54 (1.21–1.96)
2006–2008
Number of patients	894	475	159
1-year
Survival (%)	77% (74%–79%)	68% (64%–72%)	50% (42%–58%)
MRR crude	1 (reference)	1.45 (1.17–1.79)	2.61 (2.02–3.38)
MRR adjusteda	1 (reference)	1.25 (1.01–1.55)	2.27 (1.74–2.95)
5-year
Survival (%)	51% (48%–55%)b	41% (36%–45%)b	22% (16%–29%)b
MRR crude	1 (reference)	1.36 (1.17–1.58)b	2.40 (1.94–2.96)b
MRR adjusteda	1 (reference)	1.20 (1.03–1.40)b	2.11 (1.72–2.59)b
2009–2011
Number of patients	992	451	167
1-year
Survival (%)	80% (77%–82%)	69% (64%–73%)	46% (38%–54%)
MRR crude	1 (reference)	1.70 (1.36–2.12)	3.31 (2.55–4.30)
MRR adjusteda	1 (reference)	1.43 (1.14–1.80)	2.56 (1.96–3.35)
5-year
Survival (%)	53% (50%–56%)b	41% (36%–45%)b	19% (14%–25%)b
MRR crude	1 (reference)	1.44% (1.24–1.68)b	2.78 (2.29–3.37)b
MRR adjusteda	1 (reference)	1.26 (1.08–1.46)b	2.30 (1.89–2.80)b

Notes: Figures in brackets represent 95% confidence intervals;

a MRRs according to comorbidity level using Charlson score 0 as reference, adjusted for age and sex;

b predicted values.

Abbreviation: MMR, mortality rate ratio.

Figure 2 Kaplan–Meier curves for rectal cancer patients in the Central Region of Denmark for four diagnostic periods for (A) Charlson score = 0, (B) Charlson score = 1–2, and (C) Charlson score = 3+.

Table 4 One-year and 5-year survival and relative mortality after rectal cancer according to comorbidity level for each diagnostic period in the Central Region of Denmark 2000–2011

	Charlson score
	0	1–2	3+
2000–2002
Number of patients	512	163	41
1-year
Survival (%)	81% (77%–84%)	69% (62%–76%)	56% (40%–70%)
MRR crude	1 (reference)	1.76 (1.25–2.47)	2.73 (1.65–4.52)
MRR adjusteda	1 (reference)	1.46 (1.03–2.06)	2.21 (1.33–3.68)
5-year
Survival (%)	51% (47%–56%)	36% (29%–44%)	17% (8%–30%)
MRR crude	1 (reference)	1.58 (1.25–1.98)	2.50 (1.74–3.57)
MRR adjusteda	1 (reference)	1.37 (1.09–1.73)	2.00 (1.39–2.88)
2003–2005
Number of patients	427	167	41
1-year
Survival (%)	81% (77%–84%)	71% (63%–77%)	56% (40%–70%)
MRR crude	1 (reference)	1.64 (1.15–2.34)	2.74 (1.64–4.56)
MRR adjusteda	1 (reference)	1.25 (0.87–1.80)	2.40 (1.43–4.02)
5-year
Survival (%)	56% (51%–60%)	41% (33%–48%)	24% (13%–38%)
MRR crude	1 (reference)	1.56 (1.22–1.99)	2.46 (1.68–3.59)
MRR adjusteda	1 (reference)	1.27 (0.99–1.64)	2.20 (1.50–3.23)
2006–2008
Number of patients	499	194	67
1-year
Survival (%)	84% (80%–87%)	76% (70%–82%)	61% (48%–72%)
MRR crude	1 (reference)	1.52 (1.06–2.19)	2.67 (1.72–4.15)
MRR adjusteda	1 (reference)	1.13 (0.77–1.64)	1.95 (1.24–3.07)
5-year
Survival (%)	54% (50%–58%)b	43% (36%–50%)b	21% (11%–33%)b
MRR crude	1 (reference)	1.40 (1.11–1.76)b	2.33 (1.71–3.17)b
MRR adjusteda	1 (reference)	1.13 (0.89–1.44)b	1.87 (1.36–2.57)b
2009–2011
Number of patients	567	221	65
1-year
Survival (%)	87% (83%–89%)	78% (71%–83%)	60% (46%–71%)
MRR crude	1 (reference)	1.82 (1.25–2.67)	3.96 (2.48–6.33)
MRR adjusteda	1 (reference)	1.51 (1.02–2.24)	3.09 (1.91–5.00)
5-year
Survival (%)	58% (53%–62%)b	44% (37%–51%)b	22% (12%–35%)b
MRR crude	1 (reference)	1.55 (1.24–1.93)b	2.67 (1.94–3.66)b
MRR adjusteda	1 (reference)	1.33 (1.05–1.67)b	2.24 (1.62–3.10)b

Notes: Figures in brackets represent 95% confidence intervals;

a MRRs according to comorbidity level with Charlson score 0 as reference, adjusted for age and sex;

b predicted estimates.

Abbreviation: MMR, mortality rate ratio.