title: Conditional survival for long-term colorectal cancer survivors in the Netherlands: who do best?
abstract: OBJECTIVE
  With the increase in the number of long-term colorectal cancer (CRC) survivors, there is a growing need for subgroup-specific analysis of conditional survival.
  
  
  METHODS
  All 137,030 stage I-III CRC patients diagnosed in the Netherlands between 1989 and 2008 aged 15-89 years were selected from the Netherlands Cancer Registry. We determined conditional 5-year relative survival rates, according to age, subsite and tumour stage for each additional year survived up to 15 years after diagnosis as well as trends in absolute risks for and distribution of causes of death during follow-up.
  
  
  RESULTS
  Minimal excess mortality (conditional 5-year relative survival >95%) was observed 1 year after diagnosis for stage I colon cancer patients, while for rectal cancer patients this was seen after 6 years. For stage II and III CRC, minimal excess mortality was seen 7 years after diagnosis for colon cancer, while for rectal cancer this was 12years. The differences in conditional 5-year relative survival between colon and rectal cancer diminished over time for all patients, except for stage III patients aged 60-89 years. The absolute risk to die from CRC diminished sharply over time and was below 5% after 5 years. The proportion of patients dying from CRC decreased over time after diagnosis while the proportions of patients dying from other cancers, cardiovascular disease and other causes increased.
  
  
  CONCLUSIONS
  Prognosis for CRC survivors improved with each additional year survived, with the largest improvements in the first years after diagnosis. Quantitative insight into conditional relative survival estimates is useful for caregivers to inform and counsel patients with stage I-III colon and rectal cancer during follow-up.
authors.affiliation: Comprehensive Cancer Centre The Netherlands, Eindhoven, The Netherlands. Electronic address: f.vanerning@iknl.nl.
authors.forename: F N
authors.initials: FN
authors.lastname: van Erning
authors.affiliation: Comprehensive Cancer Centre The Netherlands, Eindhoven, The Netherlands.
authors.forename: L N
authors.initials: LN
authors.lastname: van Steenbergen
authors.affiliation: Comprehensive Cancer Centre The Netherlands, Eindhoven, The Netherlands; Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: V E P P
authors.initials: VEPP
authors.lastname: Lemmens
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands; Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: H J T
authors.initials: HJT
authors.lastname: Rutten
authors.affiliation: Department of Radiotherapy, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Martijn
authors.affiliation: Department of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands; Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: D J
authors.initials: DJ
authors.lastname: van Spronsen
authors.affiliation: Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands; Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands.
authors.forename: M L G
authors.initials: MLG
authors.lastname: Janssen-Heijnen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology; D015987:Effect Modifier, Epidemiologic; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult
keywords: Cause of death; Colorectal cancer; Conditional survival; Long-term survivors; Subsite