The Factors That Influence Rectal Cancer Survival

What factors influence survival rates for rectal cancer, and what is the current life expectancy based on these statistics?

A rectal cancer cell
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Rectal Cancer Survival and Life Expectancy

When faced with the uncertainty of cancer, it's human nature to want to learn as much as possible about the disease and to try to figure out how it's all going to play out. The rectal cancer survival rates presented here will help give you a sense of the problem at hand, but it's important to remember that survival rates are generalizations, and individual chances of survival may be quite different.

Keep in mind that these numbers are statistics based on past survival rates. For example, a five-year survival rate recorded in 2017 would apply to people who were diagnosed beginning in 2012 or earlier. Since new treatments have become available in the past few years, these rates may not reflect how a person with rectal cancer will do today, employing the treatments we now have.

Variables that Cannot Be Controlled

Here are several variables over which we have no control, but that may play a factor in prognosis.

Where You Live

According to a 2018 study in CA: A Cancer Journal for Clinicians, rectal cancer survival rates vary by country. While the overall five-year survival rate for rectal cancer in America is 67 percent, in Europe the rate is 61 percent. Quality of care may be a factor, but another could be the use of colorectal cancer screening programs. In general, the earlier rectal cancer is detected, the easier it is to treat.

Stage at Diagnosis

The stage at diagnosis greatly impacts rectal cancer survival rates. The average life expectancy depending on stage is listed below, but again, keep in mind that several other variables play a role.

Race and Gender

In general, the survival rate for African Americans with rectal cancer is lower than for whites with the disease. Among variables that may contribute to this disparity is the availability of health insurance.

Your gender is another factor in rectal cancer survival rates. Studies have found that, unlike many other cancers, women tend to have lower rectal cancer survival rates than men.

Tumor Markers

Tests that detect what are called tumor markers in the blood may provide greater information about prognosis with rectal cancer. We won't go into these specific measures, but it's helpful to realize that the molecular makeup of your tumor can play a role in survival. Determining these molecular characteristics will likely enhance prognosis estimates, and they guide the aggressiveness and types of treatment for individual cancer.

Controllable Variables

The factors we've discussed so far are mostly out of your control. You live where
you live and you developed cancer when you developed it. So what can you do to improve your chances of survival? Focusing on the following variables and how you can adjust them may not only help you cope with your disease, but it could make a difference in your outcome.

Exercise

Researchers at the Dana-Farber Cancer Institute in Boston found that moderate exercise can significantly increase the survival rates of colorectal cancer patients. Learn more about the impact of exercise on colorectal cancer survival.

Insurance Coverage

Those who have medical insurance generally tend to have better outcomes than those who are uninsured, in part because people without insurance tend not to receive preventative health care and may avoid necessary medical care for major health issues because of cost. This is not a variable that can be changed according to insurance coverage at the onset, but those who are uninsured or underinsured during treatment should consider their options. Your cancer center social worker may be a good place to start in determining what your options are.

Aspirin

Some studies suggest that taking aspirin increases the survival rate from colorectal cancer. It is very important to talk to your healthcare provider, however: Aspirin may interfere with your cancer treatment plan.

Vitamin D

As with aspirin, some studies suggest that vitamin D may play a role in increasing colorectal cancer survival. Add to this the fact that most Americans are deficient in vitamin D, and your healthcare provider may find that your levels are low as well. Your practitioner can order a simple blood test to determine whether this is the case, and they can recommend vitamin D3 supplements if necessary. Always talk to your healthcare provider before taking any nonprescription nutritional supplements. Some vitamin and mineral preparations can interfere with cancer treatments.

Support Community

Although not specifically studied for rectal cancer patients, it's been found that people who have advanced lung cancer tend to live significantly longer when they have more social support. Keep in mind that you can get support even if you're not feeling well enough to leave your home. Many rectal cancer communities online not only offer professional support, but they also allow you to talk to people who are facing similar challenges.

Blood Clots

Blood clots in the legs (deep vein thrombosis), which can break off and travel to the lungs (pulmonary embolism) are a significant cause of illness and death for those living with any kind of cancer. Learn about the symptoms of blood clots as well as what you can do to lower your risk of blood clots with cancer.

Other Conditions That Influence Survival Rate

In addition to the variables above, other factors can influence a person's survival rate with colorectal cancer. These can include:

  • Your Age: In general, younger people tend to do better than older people with the disease—although this can go both ways. Younger people may be more likely to have a genetic predisposition and therefore more-aggressive tumors, but their general health may be better and thus they can tolerate the most aggressive treatment plans.
  • Your Performance Status: Performance status is a way to determine how well a patient is able to conduct normal activities of daily living. Though it is used most often to determine whether a person qualifies for participation in a clinical trial, it is also associated with prognosis.
  • Your Overall Health: How healthy you are aside from cancer may determine which treatments you can tolerate, and may also influence whether you are able to exercise—a habit that improves survival.
  • Treatments received and how your tumor responds to treatment.
  • The molecular profile and grade (aggressiveness) of your cancer.
  • Perforation or obstruction of the bowel due to cancer is associated with poorer survival.

Why Statistics Are Not Predictors

Even taking into account all of the variables above, it is difficult to know how long any one person will live with colorectal cancer.

Statistics can give averages, but people are not numbers. In general, statistics tell us how patients fared with colorectal cancer in recent history. The most recent comprehensive statistics we have are often four or five years old, but since then, medicine has made significant progress in cancer treatment. In essence, then, survival rates can tell you how someone with a similar diagnosis did with an older treatment for the disease, but results from treatments that have been approved since that time may not be known for another few years.

Colon and Rectal Cancer Life Expectancy Statistics

Rectal cancer is often linked with colon cancer in cancer survival statistics; however, they have differing survival rates.

According to the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program, five-year survival rates for colon cancer (based on people diagnosed between 2009 and 2015) are:

  • Localized: 90%
  • Regional: 71%,
  • Distant: 14%
  • All Stages Combined: 63%

Five-year survival rates for rectal cancer are:

  • Localized: 89%
  • Regional: 71%,
  • Distant: 15%
  • All Stages Combined: 67%

Note that SEER's statistics apply only to the stage of the cancer when it's first diagnosed, not to whether the cancer grows, spreads, or returns after treatment. Also keep in mind that survival rates are grouped based on how far cancer has spread, but your age, overall health, the cancer's response to treatment, and other factors will also affect your prognosis. And once again, remember that people now being diagnosed with colon or rectal cancer may have a better outlook than these numbers show, because treatments improve over time.

Conclusions on Colon and Rectal Cancer Survival Rates

Many studies point out the multiple factors at play in cancer survival. Newer treatments have been approved in recent years, and others are in clinical trials. The treatment options in clinical trials must be evaluated before they are available to the public. The National Cancer Institute suggests that patients consider whether a clinical trial would be an option for their care. There are many myths about clinical trials, but the truth is that many of the best treatments available five years from now may only be available in clinical trials today.

15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. doi:10.3322/caac.21492

  2. American Cancer Society. Cancer facts & figures for African Americans.

  3. Kim SE, Paik HY, Yoon H, Lee JE, Kim N, Sung MK. Sex- and gender-specific disparities in colorectal cancer risk. World J Gastroenterol. 2015;21(17):5167-75.

  4. American Cancer Society. Tests to diagnose and stage colorectal cancer.

  5. Guercio BJ, Zhang S, Ou FS, et al. Associations of physical activity with survival and progression in metastatic colorectal cancer: results from cancer and leukemia group B (Alliance)/SWOG 80405. J Clin Oncol. 2019;37(29):2620-2631. doi:10.1200/JCO.19.01019

  6. Tolbert J, Orgera K, Singer N, Damico A. Key facts about the uninsured population. Kaiser Family Foundation.

  7. Garcia-Albeniz X, Chan AT. Aspirin for the prevention of colorectal cancer. Best Pract Res Clin Gastroenterol; 25(4-5):461-72.

  8. Morales-Oyarvide V, Meyerhardt JA, Ng K. Vitamin D and physical activity in patients with colorectal cancer: epidemiological evidence and therapeutic implications. Cancer J. 2016;22(3):223-31. doi:10.1097/PPO.0000000000000197

  9. Johnson LA, Schreier AM, Swanson M, Moye JP, Ridner S. Stigma and quality of life in patients with advanced lung cancer. Oncol Nurs Forum. 2019;46(3):318-328. doi:10.1188/19.ONF.318-328

  10. Centers for Disease Control and Prevention, Division of Cancer Prevention and Control. Side effects of cancer treatment: blood clots (deep vein thrombosis).

  11. Mauri G, Sartore-bianchi A, Russo AG, Marsoni S, Bardelli A, Siena S. Early-onset colorectal cancer in young individuals. Mol Oncol. 2019;13(2):109-131. doi:10.1002/1878-0261.12417

  12. Chen TM, Huang YT, Wang GC. Outcome of colon cancer initially presenting as colon perforation and obstruction. World J Surg Oncol. 2017;15(1):164. doi:10.1186/s12957-017-1228-y

  13. American Society of Clinical Oncology. Understanding statistics used to guide prognosis and evaluate treatment.

  14. American Cancer Society. Survival rates for colorectal cancer.

  15. National Cancer Institute. Clinical trials information for patients and caregivers. Updated February 2020.

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