영성, 몸-마음, 젠더, 생태, 평화 Scapbook

2020/03/26

Survival Rates for Colorectal Cancer

Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. They can’t tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.

Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they can’t predict what will happen in any particular person’s case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.

What is a 5-year relative survival rate?

A relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of colon or rectal cancer is 80%, it means that people who have that cancer are, on average, about 80% as likely as people who don’t have that cancer to live for at least 5 years after being diagnosed.

Where do these numbers come from?

The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute (NCI), to provide survival statistics for different types of cancer.

The SEER database tracks 5-year relative survival rates for colon and rectal cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages (stage 1, stage 2, stage 3, etc.). Instead, it groups cancers into localized, regional, and distant stages:

Localized: There is no sign that the cancer has spread outside of the colon or rectum.
Regional: The cancer has spread outside the colon or rectum to nearby structures or lymph nodes.
Distant: The cancer has spread to distant parts of the body such as the liver, lungs, or distant lymph nodes.

5-year relative survival rates for colon cancer

These numbers are based on people diagnosed with cancers of the colon between 2009 and 2015.

SEER stage	5-year relative survival rate
Localized	90%
Regional	71%
Distant	14%
All SEER stages combined	63%

5-year relative survival rates for rectal cancer

These numbers are based on people diagnosed with cancers of the rectum between 2009 and 2015.

SEER stage	5-year relative survival rate
Localized	89%
Regional	71%
Distant	15%
All SEER stages combined	67%

Understanding the numbers

These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment.
These numbers don’t take everything into account. Survival rates are grouped based on how far the cancer has spread, but your age, overall health, how well the cancer responds to treatment, and other factors will also affect your outlook.
People now being diagnosed with colon or rectal cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on people who were diagnosed and treated at least five years earlier.

*SEER = Surveillance, Epidemiology, and End Results

Colorectal Cancer Stages

After someone is diagnosed with colorectal cancer, doctors will try to figure out if it has spread, and if so, how far. This process is called staging. The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it. Doctors also use a cancer's stage when talking about survival statistics.

The earliest stage colorectal cancers are called stage 0 (a very early cancer), and then range from stages I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means cancer has spread more. And within a stage, an earlier letter means a lower stage. Although each person’s cancer experience is unique, cancers with similar stages tend to have a similar outlook and are often treated in much the same way.

How is the stage determined?

The staging system most often used for colorectal cancer is the American Joint Committee on Cancer (AJCC) TNM system, which is based on 3 key pieces of information:

The extent (size) of the tumor (T): How far has the cancer grown into the wall of the colon or rectum? These layers, from the inner to the outer, include:
- The inner lining (mucosa), which is the layer in which nearly all colorectal cancers start. This includes a thin muscle layer (muscularis mucosa).
- The fibrous tissue beneath this muscle layer (submucosa)
- A thick muscle layer (muscularis propria)
- The thin, outermost layers of connective tissue (subserosa and serosa) that cover most of the colon but not the rectum

illustration showing a cross section of the digestive tract (normal intestinal tissue) and details of the layers of the colon wall (including the mucosa (epithelium, connective tissue, thin muscle layer), submucosa, thick muscle layers, subserosa and serosa)

The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes?
The spread (metastasis) to distant sites (M): Has the cancer spread to distant lymph nodes or distant organs such as the liver or lungs?

The system described below is the most recent AJCC system effective January 2018. It uses the pathologic stage (also called the surgical stage) which is determined by examining tissue removed during an operation. This is also known as surgical staging. This is likely to be more accurate than clinical staging, which takes into account the results of a physical exam, biopsies, and imaging tests, done before surgery.

Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a person’s T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage. For more information see Cancer Staging.

Cancer staging can be complex, so ask your doctor to explain it to you in a way you understand.

AJCC Stage	Stage grouping	Stage description*
0	Tis N0 M0	The cancer is in its earliest stage. This stage is also known as carcinoma in situ or intramucosal carcinoma (Tis). It has not grown beyond the inner layer (mucosa) of the colon or rectum.
I	T1 or T2 N0 M0	The cancer has grown through the muscularis mucosa into the submucosa (T1), and it may also have grown into the muscularis propria (T2). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IIA	T3 N0 M0	The cancer has grown into the outermost layers of the colon or rectum but has not gone through them (T3). It has not reached nearby organs. It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IIB	T4a N0 M0	The cancer has grown through the wall of the colon or rectum but has not grown into other nearby tissues or organs (T4a). It has not yet spread to nearby lymph nodes (N0) or to distant sites (M0).
IIC	T4b N0 M0	The cancer has grown through the wall of the colon or rectum and is attached to or has grown into other nearby tissues or organs (T4b). It has not yet spread to nearby lymph nodes (N0) or to distant sites (M0).
IIIA	T1 or T2 N1/N1c M0	The cancer has grown through the mucosa into the submucosa (T1), and it may also have grown into the muscularis propria (T2). It has spread to 1 to 3 nearby lymph nodes (N1) or into areas of fat near the lymph nodes but not the nodes themselves (N1c). It has not spread to distant sites (M0).
	OR
	T1 N2a M0	The cancer has grown through the mucosa into the submucosa (T1). It has spread to 4 to 6 nearby lymph nodes (N2a). It has not spread to distant sites (M0).
IIIB	T3 or T4a, N1/N1c M0	The cancer has grown into the outermost layers of the colon or rectum (T3) or through the visceral peritoneum (T4a) but has not reached nearby organs. It has spread to 1 to 3 nearby lymph nodes (N1a or N1b) or into areas of fat near the lymph nodes but not the nodes themselves (N1c). It has not spread to distant sites (M0).
	OR
	T2 or T3 N2a M0	The cancer has grown into the muscularis propria (T2) or into the outermost layers of the colon or rectum (T3). It has spread to 4 to 6 nearby lymph nodes (N2a). It has not spread to distant sites (M0).
	OR
	T1 or T2 N2b M0	The cancer has grown through the mucosa into the submucosa (T1), and it may also have grown into the muscularis propria (T2). It has spread to 7 or more nearby lymph nodes (N2b). It has not spread to distant sites (M0).
IIIC	T4a N2a M0	The cancer has grown through the wall of the colon or rectum (including the visceral peritoneum) but has not reached nearby organs (T4a). It has spread to 4 to 6 nearby lymph nodes (N2a). It has not spread to distant sites (M0).
	OR
	T3 or T4a N2b M0	The cancer has grown into the outermost layers of the colon or rectum (T3) or through the visceral peritoneum (T4a) but has not reached nearby organs. It has spread to 7 or more nearby lymph nodes (N2b). It has not spread to distant sites (M0).
	OR
	T4b N1 or N2 M0	The cancer has grown through the wall of the colon or rectum and is attached to or has grown into other nearby tissues or organs (T4b). It has spread to at least one nearby lymph node or into areas of fat near the lymph nodes (N1 or N2). It has not spread to distant sites (M0).
IVA	Any T Any N M1a	The cancer may or may not have grown through the wall of the colon or rectum (Any T). It might or might not have spread to nearby lymph nodes. (Any N). It has spread to 1 distant organ (such as the liver or lung) or distant set of lymph nodes, but not to distant parts of the peritoneum (the lining of the abdominal cavity) (M1a).
IVB	Any T Any N M1b	The cancer might or might not have grown through the wall of the colon or rectum (Any T). It might or might not have spread to nearby lymph nodes (Any N). It has spread to more than 1 distant organ (such as the liver or lung) or distant set of lymph nodes, but not to distant parts of the peritoneum (the lining of the abdominal cavity) (M1b).
IVC	Any T Any N M1c	The cancer might or might not have grown through the wall of the colon or rectum (Any T). It might or might not have spread to nearby lymph nodes (Any N). It has spread to distant parts of the peritoneum (the lining of the abdominal cavity), and may or may not have spread to distant organs or lymph nodes (M1c).

* The following additional categories are not listed in the table above:

TX: Main tumor cannot be assessed due to lack of information.
T0: No evidence of a primary tumor.
NX: Regional lymph nodes cannot be assessed due to lack of information.

Last Medical Review: February 21, 2018 Last Revised: February 21, 2018

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.

EARLY DETECTION, DIAGNOSIS, AND STAGING

Bowel cancer (Colorectal cancer) in Australia statistics

The following material has been sourced from the Australian Institute of Health and Welfare

Colorectal cancer incorporates ICD-10 cancer codes C18 (Malignant neoplasm of colon), C19 (Malignant neoplasm of rectosigmoid junction) C20 (Malignant neoplasm of the rectum), and C26 (Malignant of other digestive organs): Incidence (C18–C20), mortality (C18–C20, C26.0)

Estimated number of new cases of colorectal cancer diagnosed in 2019

16,398 = 9,069males + 7,329 females

Estimated % of all new cancer cases diagnosed in 2019

11%

Estimated number of deaths from colorectal cancer in 2019

5,597 = 3,009 males + 2,588 females

Estimated % of all deaths from cancer in 2019

11%

Chance of surviving at least 5 years (2011–2015)

70%

People living with colorectal cancer at the end of 2014 (diagnosed in the 5 year period 2010 to 2014)

54,046

New cases

Colorectal cancer was the third most commonly diagnosed cancer in Australia in 2015. It is estimated that it will remain the third most commonly diagnosed cancer in 2019.

In 2015, there were 15,604 new cases of colorectal cancer diagnosed in Australia (8,573 males and 7,031 females). In 2019, it is estimated that 16,398 new cases of colorectal cancer will be diagnosed in Australia (9,069 males and 7,329 females). In 2019, it is estimated that the risk of an individual being diagnosed with colorectal cancer by their 85th birthday will be 1 in 14 (1 in 12 males and 1 in 17 females).

Figure 1. Estimated most common cancers diagnosed, 2019

Notes

Data sourced from AIHW 2018 Cancer Data in Australia, ACIM books, and Cancer in Australia 2019 report and supplementary data tables
More information about incidence rates for the most common cancers diagnosed can be found on the NCCI website in the ‘Cancer incidence’ section (https://ncci.canceraustralia.gov.au/diagnosis/cancer-incidence/cancer-incidence)

In 2015, the age-standardised incidence rate was 57 cases per 100,000 persons (67 for males and 49 for females). In 2019, it is estimated that the age-standardised incidence rate will reduce to 54 cases per 100,000 persons (63 for males and 46 for females). The incidence rate for colorectal cancer is expected to increase with age, peaking at age group 80–84.

Figure 2. Age-standardised incidence rates for colorectal cancer, 1982 to 2015, by sex

Notes

Data sourced from AIHW 2018 Cancer Data in Australia, ACIM books, and Cancer in Australia 2019 report and supplementary data tables
More information about incidence rates for colorectal cancer over time, by age, sex, Indigenous status, remoteness, and socioeconomic status (SES) can be found on the NCCI website in the ‘Cancer incidence’ section (https://ncci.canceraustralia.gov.au/diagnosis/cancer-incidence/cancer-incidence)

The number of new cases of colorectal cancer diagnosed increased from 6,994 (3,529 males and 3,465 females) in 1982 to 15,604 in 2015. Over the same period, the age-standardised incidence rate increased steadily from 58 cases per 100,000 persons (67 for males and 52 for females) in 1982 to a peak of 66 cases per 100,000 in 2000 (81 for males and 54 for females) and 2001 (79 for males and 56 for females) before decreasing to 57 cases per 100,000 in 2015.

Deaths

In 2016, colorectal cancer was the most common cause of cancer death in Australia. It is estimated that it will remain the second most common cause of death from cancer in 2019.

In 2016, there were 5,375 deaths from colorectal cancer in Australia (2,936 males and 2,439 females). In 2019, it is estimated that there will be 5,597 deaths (3,009 males and 2,588 females). In 2019, it is estimated that the risk of an individual dying from colorectal cancer by their 85th birthday will be 1 in 43 (1 in 37 males and 1 in 51 females).

Figure 3. Estimated most common causes of cancer death, 2019

Notes

Data sourced from AIHW 2018 Cancer Data in Australia, ACIM books, and Cancer in Australia 2019 report and supplementary data tables
More information about mortality rates for the most common causes of cancer death can be found on the NCCI website in the ‘Cancer mortality’ section (https://ncci.canceraustralia.gov.au/outcomes/cancer-mortality/cancer-mortality)

In 2016, the age-standardised mortality rate was 19 deaths per 100,000 persons (23 for males and 15 for females). In 2019, it is estimated that the age-standardised mortality rate will be 18 deaths per 100,000 persons (21 for males and 15 for females). The mortality rate for colorectal cancer is expected to increase with age.

Figure 4. Age-standardised mortality rates for colorectal cancer, 1968 to 2016, by sex

Notes

Data sourced from AIHW 2018 Cancer Data in Australia, ACIM books, and Cancer in Australia 2019 report and supplementary data tables
More information about mortality rates for colorectal cancer over time, by age, sex, Indigenous status, remoteness, and socioeconomic status (SES) can be found on the NCCI website in the ‘Cancer mortality’ section (https://ncci.canceraustralia.gov.au/outcomes/cancer-mortality/cancer-mortality)

The number of deaths from colorectal cancer increased from 2,500 (1,218 males and 1,282 females) in 1968 to 5,375 in 2016. Over the same period, the age-standardised mortality rate decreased from 31 deaths per 100,000 persons (36 for males and 28 for females) in 1968 to 19 deaths per 100,000 in 2016.

Survival

In 2011–2015, individuals diagnosed with colorectal cancer both males and females had a 70% chance of surviving for five years compared to their counterparts in the general Australian population. Between 1986–1990 and 2011–2015, five-year relative survival from colorectal cancer improved from 52% to 70%.

Figure 5. 5-year relative survival from colorectal cancer, 1986–1990 to 2011–2015, by sex

Notes

Data sourced from AIHW 2018 Cancer Data in Australia, ACIM books, and Cancer in Australia 2019 report and supplementary data tables
More information about 5-year relative survival rates for colorectal cancer over time, by age, sex, Indigenous status, remoteness, and socioeconomic status (SES) can be found on the NCCI website in the ‘Relative survival rate’ section (https://ncci.canceraustralia.gov.au/outcomes/relative-survival-rate/5-year-relative-survival)

Prevalence

At the end of 2014, there were 13,272 people living who had been diagnosed with colorectal cancer that year, 54,046 people living who had been diagnosed with colorectal cancer in the previous 5 years (from 2010 to 2014) and 138,072 people living who had been diagnosed with colorectal cancer in the previous 33 years (from 1982 to 2014).

For more information, see Colorectal cancer on the NCCI website

The National Cancer Control Indicators (NCCI) are a set of indicators across the continuum of cancer care, from Prevention and Screening through to Diagnosis, Treatment, Psychosocial care, Research and Outcomes. The NCCI website allows users to see visual representations of data on each indicator through interactive charts.

Last Updated

대장암 3기 5년 후 생존율은 60~70%, 완치율은 70% 정도다.

유상무 수술, 대장암 3기 완치율은 어느 정도일까?

이해나 헬스조선 기자
장서인 헬스조선 인턴기자

입력 2017.04.10 11:14

개그맨 유상무가 오늘(10일) 대장암 수술을 받는다/사진=JTBC '비정상회담' 캡쳐

개그맨 유상무가 오늘(10일) 대장암 수술을 받는다.

지난 7일 유상무가 대장암 3기 진단을 받고 투병 중이라는 소식이 전해졌다. 대장암은 갑상선암·위암에 이어 세 번째로 국내에서 많이 발생하는 암이다. 50세 이후 주로 발생하지만, 최근에는 40대 이하의 젊은 대장암 환자도 늘고 있다. 대장암 3기는 보통 림프절까지 암세포가 침범한 상태이며, 5년 후 생존율은 60~70%, 완치율은 70% 정도다.

전체 대장암 환자의 10~15%는 유전적 요인이 발병 원인인 것으로 알려졌다. 이 밖에도 비만·좌식생활·스트레스·잦은 육류섭취·흡연·음주 등이 대장암을 유발할 수 있다.

대장암의 주요 증상으로는 배변 습관의 변화·설사·변비·혈변·복통·복부팽만·피로감·복부의 혹 등이 있다. 하지만 초기에는 대부분 아무런 증상이 없어서 증상이 나타날 때는 이미 병이 상당히 진행된 상태인 경우가 많다. 따라서 대장암 환자 가족력이 있거나, 변의 모양·색에 변화가 생겼다면 대장암 검진을 받아보는 게 좋다.

최근 대장암 수술의 60~70%는 복강경 수술로 이뤄지고 있다. 복강경 수술은 배꼽부위를 1cm 가량 절개해 카메라를 넣은 후 모니터를 보며 수술을 하는 식이다. 배를 15cm가량 절개하던 과거 수술에 비해 통증이 적고 회복이 빠르다.

출처 : http://health.chosun.com/site/data/html_dir/2017/04/10/2017041001197.html
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[대장암]3기 생존율 50~60%…수술·항암치료 견디면 완치율↑
[뉴시스] 입력 2017.04.09

【서울=뉴시스】강수윤 기자 = 개그맨 유상무가 대장암 3기 판정을 받고 투병 중인 것으로 알려지면서 대장암 5년 생존율과 완치 가능성에 관심이 쏠리고 있다.

9일 의학계에 따르면 대장암은 대장에 생긴 암세포로 이뤄진 악성종양을 말한다. 1980년대 이후 꾸준히 증가하는 암이다. 대장암은 갑상선암, 위암에 이어 3번째로 많이 발생하는 암으로 꼽힌다.

대장암은 대장의 상피세포에서부터 암세포가 발생한다. 암이 발생하는 위치에 따라 결장에 생기는 암을 결장암, 직장에 생기는 암을 직장암, 이를 통칭해 대장암 또는 결장 직장암이라고 부른다. 다른 암들에 비해 다른 신체부위로 전이될 가능성이 낮은 종류의 암으로 분류된다.

대장암은 대장에서 용종(폴립)이 선종으로부터 성장된 것이다. 대부분의 경우에는 양성으로 성장하나 일부는 악성 종양으로 발전하는 경우가 있다. 대장암은 주로 대장 내시경을 통해 발견된다.

유씨가 판정받은 대장암 3기와 4기를 보통 말기라고 한다. 대장암 3기는 전이가 되지 않은 경우 대장암 4기는 전이가 된 경우다.

대장암 3기는 암세포가 점막층을 벗어나 림프절로 전이가 되며 대장 주위에 있는 장기로부터 암세포가 침투된 단계를 말한다. 3기의 경우 수술과 항암치료를 잘 견뎌내면 완치에 성공할 가능성도 높다고 알려져 있다.

대장 벽면에 발생한 대장암 1기와 2기처럼 초기에 발견된 경우에는 80~90%의 생존율을 보인다. 수술만으로 치료를 하고 암을 극복한 뒤 일상으로 돌아오는 경우가 많다.

이 치료 시기를 놓친 경우 대장암 3기로 진행된다. 대장암3기와 4기처럼 말기암 환자의 경우 생존율은 60%이하로 급격히 하락되며 힘든 암치료 시간을 보내게 된다. 대장암 4기는 대장을 포함한 다른 장기로 전이가 된 상태이므로 대장암 생존율이 5%정도로 급격하게 낮아진다.

대장암 3기의 경우 수술 요법과 항암제를 이용한 화학 요법을 병행 치료한다. 암덩어리가 심하게 커지면 대장암 4기는 화학요법을 사용해도 완치가 어렵다. 4기는 수술과 항암화학요법 또는 방사선치료를 병행한다.

shoon@newsis.com