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Background <p>Colorectal cancer ranks second in cancer-related deaths, but management has significantly evolved over the past two decades with increasing use of systemic therapy, organ preservation, and a lowering of the cancer screening age alongside new threats such as COVID-19. Thus, we explored temporal trends in cause of death (COD) among colon and rectal cancer patients.</p> Methods <p>The Surveillance, Epidemiology, and End Results database queried colon and rectal adenocarcinoma adults [2004–2021]. COVID-19 data were available for the years 2020–2021. Multinomial logistic regression estimated patient and tumor effects on COD.</p> Results <p>Among 400,747 patients, 52% with colon cancer and 51% with rectal cancer died. Of colon cancer deaths, 58% died of their primary malignancy and 20% from cardiopulmonary disease. Meanwhile, 72% of rectal cancer patients died from their cancer, followed by cardiopulmonary disease (13%). COVID-19 contributed to 7% and 5% of deaths from 2020 to 2021 for colon and rectal cancer patients, respectively. For localized tumors, the most common COD for colon cancer was cardiopulmonary disease (40%), while colorectal cancer (48%) remained the leading COD for rectal cancer. Over time, colon cancer-related deaths declined while rectal cancer-related deaths remained stable. In the multinomial model, lower-staged patients further out from their diagnosis were less likely to die from their primary malignancy.</p> Conclusion <p>In this US cohort, colon cancer-related deaths have declined, but most rectal cancer patients die from their primary malignancy. Localized colon cancer patients were more likely to die from non-cancer causes, highlighting the importance of proactive comorbidity management during and after treatment to improve survival.</p>

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Temporal trends in the cause of death of patients with colon and rectal cancer

  • 期刊论文

  • 发表日期：

    2026年4月3日

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  • Lauren Weaver,
  • Catherine G. Tran,
  • Elle Kalbfell,
  • Alexander Troester,
  • Sarah L. Mott,
  • Pridvi Kandagatla,
  • Ajay Prakash,
  • Schelomo Marmor,
  • Imran Hassan,
  • Paolo Goffredo

摘要

Background

Colorectal cancer ranks second in cancer-related deaths, but management has significantly evolved over the past two decades with increasing use of systemic therapy, organ preservation, and a lowering of the cancer screening age alongside new threats such as COVID-19. Thus, we explored temporal trends in cause of death (COD) among colon and rectal cancer patients.

Methods

The Surveillance, Epidemiology, and End Results database queried colon and rectal adenocarcinoma adults [2004–2021]. COVID-19 data were available for the years 2020–2021. Multinomial logistic regression estimated patient and tumor effects on COD.

Results

Among 400,747 patients, 52% with colon cancer and 51% with rectal cancer died. Of colon cancer deaths, 58% died of their primary malignancy and 20% from cardiopulmonary disease. Meanwhile, 72% of rectal cancer patients died from their cancer, followed by cardiopulmonary disease (13%). COVID-19 contributed to 7% and 5% of deaths from 2020 to 2021 for colon and rectal cancer patients, respectively. For localized tumors, the most common COD for colon cancer was cardiopulmonary disease (40%), while colorectal cancer (48%) remained the leading COD for rectal cancer. Over time, colon cancer-related deaths declined while rectal cancer-related deaths remained stable. In the multinomial model, lower-staged patients further out from their diagnosis were less likely to die from their primary malignancy.

Conclusion

In this US cohort, colon cancer-related deaths have declined, but most rectal cancer patients die from their primary malignancy. Localized colon cancer patients were more likely to die from non-cancer causes, highlighting the importance of proactive comorbidity management during and after treatment to improve survival.