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Standard 1.12 Public Reporting of Outcomes for Colon Cancer

UH-Portage Medical Center (UH-PMC): Colon Cancer, 2018

Introduction: Colon cancer is the third most commonly diagnosed cancer in the U.S. and the third most common cause of cancer death in both men and women. Both sexes have a 4.5% lifetime risk of getting colon cancer. An estimated 140,250 new cases of colon cancer will be diagnosed in 2018 and there will be approximately 50,630 deaths from the cancer this year. Risk factors include increasing age, family history of colorectal cancer, certain genetic conditions (including Familial Adenomatous Polyposis, Attenuated Familial Adenomatous Polyposis, Lynch Syndrome, Gardener’s Syndrome, Peutz-Jeghers’s Syndrome, Juvenile Polyposis Syndrome, MYH-associated polyposis, Turcot’s Syndrome, and Muir-Torre Syndrome), male gender, black race, physical inactivity, dietary factors, inflammatory bowel disease, heavy alcohol use and smoking.

Incidence of colon cancer by stage: Cases diagnosed at UH-PMC vs. All Ohio hospitals (2014-2015)
UH-PMC (N/%) Ohio hospitals (N/%)
Stage 0 0 (0%) 366 (5%)
Stage I 14 (22%) 1470 (21%)
Stage II 13 (21%) 1806 (26%)
Stage III 21 (33%) 1823 (26%)
Stage IV 15 (24%) 1535 (22%)
Total 63 6994

The incidence rates according to stage for patients diagnosed at UH-PMC are very similar to those in other Ohio hospitals.

Age at diagnosis: Ages at time of diagnosis of colon cancer: UH-PMC vs. Ohio hospitals (2014-2015)
Age (in years) UH-PMC Ohio hospitals
20-29 0% 1%
30-39 0% 2%
40-49 6% 6%
50-59 6% 18%
60-69 25% 26%
70-79 24% 25%
80-89 32% 18%
90+ 6% 4%

Compared to other patients diagnosed in Ohio, UH-PMC patients tended to be slightly older at the time of diagnosis.

Treatment: The initial course of treatment for early stage colon cancer should be surgical resection. For patients with more advanced disease or who cannot undergo surgery for other reasons, chemotherapy, radiation therapy, ablation or embolization techniques, targeted therapy or other palliative measures may be offered.

First course of treatment: UH-PMC vs. Other Ohio hospitals (2014-2015)
Category UH-PMC (N/%) Ohio hospitals (N/%)
Surgery only 38 (60%) 4157 (57%)
Surgery + chemotherapy 16 (25%) 1815 (25%)
Chemotherapy only 4 (6%) 273 (4%)
No treatment 4 (6%) 53 (7%)
Surgery + RT 1 (2%) 5 (<1%)
Radiation + chemo 0 (0%) 19 (<1%)
Surgery + RT + chemo 0 (0%) 75 (1%)
Surgery + chemo + hormonal tx 0 (0%) 75 (1%)
Total 63 7321

Depending on the cancer stage and the patient’s medical condition, various treatment options are available. For patients diagnosed at UH-PMC, their first courses of treatment were closely in line with other Ohio hospitals.

Prevention and screening: A critical component of the fight against cancer is prevention. In the spring of 2018, 84 people participated in the UH-PMC Colon Cancer Prevention Program conducted by Mindy Gusz, UH-Portage Community Outreach Coordinator, Dr. Jonathan Umbel, UH-Portage Gastroenterology, and the American Cancer Society. The participants received education on colorectal cancer and then took a short quiz. They answered 90% of the questions correctly. As a result, some were screened for Open Access; several are in process and others have had medical visits.

Conclusions: Colon cancer remains a devastating disease as well as a national and global public health problem, ranking third in causes of cancer death in the US and in the world. The incidence of colon cancer by stage for those diagnosed at UH-PMC closely reflects those throughout the rest of Ohio. The average age of patients diagnosed at UH-PMC was slightly greater that other Ohio patients, but their types of first course of treatments were very similar. Although treatment of colon cancer is often effective, the ultimate goal in the war on cancer is prevention. Preventing the development of cancer through lifestyle changes and removal of precancerous lesions will have favorable individual and global implications on incidence and survival of colon cancer. Through better screening and prevention programs, improvement in the effectiveness of various treatment modalities and in the better understanding of the tumor microenvironment, including the pathobiology of cancer genesis, growth, spread and resistance to treatment, we will, someday, eliminate cancer.

Frederick P. Marquinez, M.D.
Chairman, UH-Portage Medical Center Cancer Committee

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