Purpose: On average, VA patients are older and sicker than is the general population. Our objectives were to provide an overview of VA colorectal (CRC) incidence and make comparisons with the Surveillance, Epidemiology, and End Results (SEER) data, which provides U.S. cancer statistics.
Background: About 3,400 incidents of CRC are reported in the Veterans Affairs Central Cancer Registry (VACCR) annually. This equates to nearly 9% of VA cancers.
Methods/Data Analysis: Data were obtained from VACCR for incident CRC diagnosed/treated in VA from fiscal year (FY) 2009 to 2012. Using VHA Support Service Center information about the distribution of VA health care system enrollees for corresponding years, we made age and gender adjustments for the underlying VA population. Colorectal incidence among VA patients was descriptively compared with projected national 2014 CRC-specific SEER and supporting data sources.
Results: From FY 2009 to 2012, we identified 15,205 VA patients nationwide. For analysis, there were 12,551 patients (n = 322, 2.6% women; n = 12,229, 97.4% men). Among patients in the VACCR, the most common tumor location was proximal colon (n = 4,830, 38%), followed by rectum (n = 3,907, 31%), distal colon (n = 3,240, 26%), and other colon (n = 574, 5%). These percentages are comparable with those of SEER, in which proximal colon and rectum are most common. Among patients in the VACCR, SEER summary stage distribution was 44% (n = 5,517) local, 36% (n = 4,488) regional, 17% (n = 2,091) distant, and 4% (n = 455) unknown. These percentages also align with those of SEER, in which about 40% of CRC cases are diagnosed locally. Mirroring SEER, among the VACCR, overall CRC incidence rate decreased from 0.22 to 0.16 cases per 1,000 veterans in FYs 2009 and 2012, respectively.
Implications: VACCR data indicate that incident CRC in FY 2009 to 2012 approximated SEER projections during a similar time frame. National VA CRC incidence, location, and stage distribution are also similar. This suggests that despite VA patients being more complex than their general population counterparts, VA patients are generally diagnosed with comparable CRC locations and stages. This analysis also suggests that, like SEER, the VACCR may have utility for epidemiologic tracking and research.
