Differences in the management and survival of metastatic colorectal cancer in Europe. A population-based study

Working Group on Colorectum

Research output: Contribution to journalArticlepeer-review


Background: The management regarding metastatic colorectal cancer throughout Europe is not well known. Aims: To draw a European comparison of the management and prognosis of metastatic colorectal cancers. Methods: Factors associated with chemotherapy administration were identified through logistic regressions. Net survival was estimated and crude probabilities of death related to cancer and other causes using a flexible cumulative hazard model. Results: Among the 13 227 patients with colorectal cancer diagnosed between 2010 and 2013 in cancer registries from 10 European countries, 3140 were metastatic. 62% of metastatic patients received chemotherapy. Compared to Spain, the related adjusted odds ratios ranged from 0.7 to 4.0 (P<0.001) according to country. The 3-year net survival by country ranged between 16% and 37%. The survival gap between countries diminished from 21% to 10% when adjusting for chemotherapy, age and sex. Geographical differences in the crude probability of death related to cancer were large for patients <70 or ≥80 years at diagnosis. Conclusion: Heterogeneity in the application of European guidelines partly explain these differences. General health between populations, accessibility to a reference centre, or provision of health care could also be involved. Further population-based studies are warranted to disentangle between these possible explanations.

Original languageEnglish
Pages (from-to)639-645
Number of pages7
JournalDigestive and Liver Disease
Issue number5
Publication statusPublished - May 2021


  • Colorectal cancer
  • Disease Management
  • Europe
  • Metastasis
  • Registries
  • Survival

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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