Demographic Description of Rectal Cancer Patients Treated at Indiana University between 2019 and 2022

Abstract

Background: There have been significant recent advances in rectal cancer treatment such that some patients receiving chemotherapy and radiation have no identifiable cancer on posttreatment imaging (complete clinical response, cCR). Historically, these patients would undergo surgery as the next step; however, guideline changes now allow these patients the option to forgo surgery and enter close monitoring for recurrence (watch and wait, WW). This study aimed to examine patients with rectal cancer treated within the Indiana Health system around the time WW started being offered.

Methods: We conducted a retrospective chart review of patients with rectal cancer diagnosed between 2019 and 2022 and treated within the Indiana Health system. Demographic, treatment, and recurrence information were abstracted into RedCap. Descriptive statistics were generated in Excel, version 16.98.

Results: A total of 100 patients (mean age 58.3 ± 12.70 years, 34% female, 66% male) with rectal cancer were reviewed. Of these patients: 88% were White, 9% were Black, and 3% did not report their race. 94% of these patients were not Hispanic or Latino, 4% were Hispanic or Latino, and 2% did not report their ethnicity. 21% of patients were single, 54% married, 10% divorced, 10% widowed, 3% identified as other (life partners or separated), and 2% did not report. 35% of the group had private insurance, 63% government insurance, and 2% were uninsured. 70.33% are still living, and 29.67% are deceased. Overall, 18.82% of patients had a cCR, with 25.00% entering WW. Of those WW patients, 50.00% had a recurrence.

Potential Impact: Our data demonstrated a low number of patients entering WW after achieving a cCR, with 50% ultimately having a recurrence of their rectal cancer, while non-WW patients had 21.18% recurrence. Future studies will examine ongoing trends in rectal cancer treatment and outcomes as WW uptake increases over time.