Stage 4 Colon Cancer Survival Rate By Age

Race plays a central, albeit indirect, role in cancer survival rates due mainly to the lack of access to quality healthcare. This is a narrative that not only affects people with colon cancer but all other health conditions as well.

People in State’s most deprived areas have higher risk of dying from cancer, report finds

Survival from cancers improving but outcome disparities between most and least deprived unchanged, National Cancer Registry Ireland says

Wed Feb 1 2023 – 00:01

People living in the most deprived areas have a 28 per cent higher risk of dying from cancer compared to those living in the most affluent parts of the State, according to a new report.

The difference in five-year survival rates remains sizeable even after adjusting for age, gender and cancer types, according to National Cancer Registry Ireland (NCRI).

Although cancer incidence rates have fallen and survival rates have improved over time across the majority of cancers and for all sectors of society, there is no evidence of any reduction in disparities between those living in the least and the most deprived areas, it says.

The incidence of stomach, lung and cervical cancers is higher in more deprived areas, while more affluent areas have a higher incidence of breast, prostate, and melanoma and non-melanoma skin cancer.

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Those in the most deprived areas were most likely to present late with breast and prostate cancers, but there were no disparities in stage of presentation for lung and colorectal cancers.

The incidence of cancer among men in the most deprived areas is 7 per cent higher compared to those in areas with least deprivation. For women, the difference is 5 per cent, according to the NCRI report.

“These important data underline the known links between socioeconomic deprivation and cancer incidence and survival, with no major reductions in disparities between groups over the time periods examined,” chair of the NCRI board Dr Jerome Coffey said. “Prevention, screening and early diagnosis are major elements of the National Cancer Strategy 2017-2026 and will have to remain as priorities in subsequent strategies.”

A range of potential factors may contribute to such disparities, the NCRI says, including differences in general health, exposure to particular risk factors, health-seeking behaviour that can influence early detection, access to healthcare, or other factors that may be linked to socioeconomic or geographic factors.

Tackling inequalities in cancer outcomes is emerging as a new priority in health across the Europe. An OECD report on Ireland’s performance in tackling cancer, to be published on Wednesday, is expected to make similar findings to that of the NCRI about differences in incidence and outcomes across the socioeconomic divide.

According to the Irish Cancer Society, opportunities to detect cancer early are being missed and patients and their families are “paying the price”. The impact is being felt the greatest by those on lower incomes who cannot afford to skip the public queue by paying for tests privately, chief executive Averil Power will tell the Oireachtas health committee.

“Our central concern is that, in Ireland today, people are not being given the best chance of surviving cancer and having a good quality of life. The earlier cancer is caught, the easier it is to treat and the greater the person’s chances are of surviving the disease.”

The five-year survival rate for colorectal cancer is 95 per cent if diagnosed at stage I but falls to 10 per cent at stage IV, Ms Power will point out, while for breast cancer the survival rate falls from 94 per cent to 19 per cent when diagnosed late.

“Early diagnosis can literally be the difference between life and death,” she will tell the committee. However, more than 200,000 people are waiting for a vital radiology scan, 150,000 of them for longer than three months, despite the target in Sláintecare being just 10 days.

Paul Cullen

Paul Cullen is Health Editor of The Irish Times

How long will a person with stage 4 colon cancer live?

Stage 4 colon cancer occurs when cancer in the colon spreads, or metastasizes, to other tissues and organs. Colon cancer most often spreads to the liver, but it may also reach the lungs, the lymph nodes, or the lining of the abdominal cavity.

The American Cancer Society (ACS) note that the 5-year relative survival rate for people with stage 4 colon cancer that has spread is 14%.

However, everyone is different, and other factors contribute to a person’s survival rate.

The correct diagnosis of colon cancer may take patience, as doctors use many tests to detect and locate cancer.

If they identify cancer, they will also use more tests to see whether it has spread.

The tests and processes that can aid a colon cancer diagnosis include:

• a physical examination
• blood tests
• a colonoscopy to look inside the rectum
• a biopsy, in which the doctor takes a sample of tissue and sends it to a laboratory for analysis
• molecular testing to help identify specific characteristics of the tumor that may be important for treatment
• imaging tests, such as CT, PET, ultrasound, or MRI scans, to see whether cancer has spread
• a chest X-ray to check whether cancer has spread to the lungs

After running all of the necessary tests, a doctor will discuss the diagnosis with the individual.

Anyone who receives a stage 4 colon cancer diagnosis will have to make some decisions about the way forward, particularly regarding treatment options.

It is important to discuss all of the options with a doctor and to understand the goal of each treatment.

The treatment options available to people with stage 4 colon cancer are more limited than those suitable for the earlier stages of this cancer. However, there are still some treatment options to consider, as well as other factors to keep in mind.

Surgery

When cancerous cells have spread to distant organs and tissues, surgery is unlikely to cure cancer. There are some cases in which surgery may still be a good option, though.

If a scan reveals that the cancer has only spread to a few small areas, surgery may still be possible. By surgically removing the cancerous cells, doctors hope to help the person live longer.

These surgeries will involve the removal of part of the colon as well as the nearby lymph nodes. Additional surgery may remove the areas of tissue into which the cancer has spread. Doctors will typically also recommend chemotherapy, either before or after the surgery.

If the tumor cells are too large to remove, or there are too many of them, doctors will recommend chemotherapy before the person undergoes any surgical procedures. If this shrinks the tumors, they may then ask a surgeon to proceed with the surgery.

Doctors may also need to perform additional surgical procedures if the cancerous growth is likely to obstruct the colon or is already blocking it. In some cases, minimally invasive surgery, such as placing a stent, may be possible. Surgeons can place a stent, which is a hollow tube that typically consists of mesh metal or plastic, into the colon during a colonoscopy. When successful, a stent may help keep the colon open and make more invasive surgery unnecessary.

Doctors may also recommend a diverting colostomy, which essentially cuts the colon above the cancerous tissue and diverts the waste from the body out through a small opening in the skin.

Chemotherapy

Share on Pinterest Chemotherapy is a primary treatment for advanced cancer.

If the colon cancer has spread too far for surgery to be effective, chemotherapy is the primary treatment option.

Most people with stage 4 colon cancer will receive chemotherapy or specific targeted therapies to help control the cancer progression or symptoms.

Doctors may recommend some treatment regimens that include a targeting drug, which targets either the vascular endothelial growth factor (VEGF) pathway or the epithelial growth factor receptor (EGFR) pathway.

The choice between regimens will vary in each situation. The most suitable option will depend on the types of treatment that a person has had before, their overall health, and their responsiveness to treatment.

It is not uncommon for doctors to try multiple treatments. If the cancer does not respond to the first treatment, they may stop that treatment and start another instead.

Radiation therapy

Doctors may also recommend radiation therapy in late-stage colon cancer to help reduce symptoms such as pain and discomfort. This treatment might even shrink the tumor for a time, but it will not usually cure the cancer.

Hepatic artery infusion

A hepatic artery infusion may be a treatment option for people with colon cancer that has spread to the liver. Hepatic artery infusion is a type of regional chemotherapy, which involves delivering a chemotherapy drug directly into the hepatic artery in the liver. This treatment may help destroy cancer cells without harming the healthy liver cells in the process.

Ablation or embolization

Ablation or embolization may be appropriate for people who have metastatic or reoccurring colorectal cancer that causes a few tumors in the lung or liver that are less than 4 centimeters across.

Ablation uses either radio frequencies, microwaves, or alcohol — which people also call percutaneous ethanol injection (PEI) — to target and kill cancer cells while leaving the surrounding tissues relatively unharmed.

During embolization, a doctor will inject substances into the blood vessels to try to block or reduce the blood flow to cancer cells in the liver.

Palliative care

If cancer progresses to many distant organs and tissues, surgery may not help extend a person’s lifespan. Other treatment options can cause discomfort and may produce additional symptoms that make the person’s quality of life worse.

In these cases, people may decide against medical treatment that seeks to cure the cancer and instead opt for palliative care to try to make living more comfortable.

Palliative care will typically involve finding ways to manage pain and reduce a person’s symptoms so that they can live comfortably for as long as possible.

Share on Pinterest A person’s responsiveness to treatment will depend on a number of factors, such as age and general health.

As the ACS note, colon cancer is the third most commonly diagnosed cancer in both males and females in the United States. One in 22 men and one in 24 women will receive a colon cancer diagnosis during their lifetime.

Stage 4 colon cancer is late-stage cancer in which the disease has spread to other tissues or organs in the body and is, therefore, more difficult to treat. Treatment may only be partially successful, and cancer may be more likely to return after treatment.

The ACS note that the 5-year relative survival rate for stage 4 colon cancer is 14%. However, this does not account for other factors that may affect individual survival rates.

For instance, the success of particular treatment methods may vary among individuals, with treatments that work very well for some people having little effect in others.

Additionally, experts base these statistics on past cases. As treatments tend to get better over time, survival rates may also improve as more effective treatments become available.

Individual factors can also play a significant role in a person’s outcome. For instance, the age and overall health of an individual may affect their responsiveness to treatment.

The rate of cancer progression may change the outlook as well. If the cancer causes complications, such as a blockage in the colon or a hole in the bowel wall, the person’s outlook is likely to change.

This survival statistic also only applies to stage 4 colon cancer when doctors first diagnose it. The survival rate will be different for those in whom the cancer has spread further or returned after treatment.

Stage 4 colon cancer is late-stage cancer. Life expectancy is lower than it is for earlier stages of cancer. The 5-year relative survival rate for stage 4 colon cancer that has spread to other parts of the body is about 14%. However, other factors, such as the chosen treatment methods and the person’s overall health, contribute to life expectancy.

Although there are often still several treatment options available, including surgery and chemotherapy, some people with late-stage cancer choose not to have medical treatment and to seek palliative care instead.

Anyone who receives a diagnosis of stage 4 colon cancer should work closely with their medical team to discuss all the treatment options and decide what will best suit their needs.

Last medically reviewed on May 21, 2019

• Colorectal Cancer
• Cancer / Oncology

How we reviewed this article:

Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Colon cancer treatment (PDQ®) — patient version. (2019).
  https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq
• Colorectal cancer. (n.d.).
  https://www.cancer.org/cancer/colon-rectal-cancer/
• Colorectal cancer facts & figures. (n.d.).
  https://www.cancer.org/research/cancer-facts-statistics/colorectal-cancer-facts-figures.html

Colon Cancer Survival Rates by Stage and Types

Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator.

Doru Paul, MD, is board-certified in internal medicine, medical oncology, and hematology.

Colon cancer affects roughly 150,000 Americans each year, resulting in around 53,000 deaths, according to data from the National Cancer Institute. It is today the fourth leading cause of cancer in the United States and the third leading cause of cancer-related deaths.  

With advances in diagnosis and treatment, the mortality rate has literally been cut in half since the mid-1980s. Today, 64.6% of people with colon cancer can expect to live for at least five years following their diagnosis; others live for far longer.  

Numerous factors can influence survival times, including the type and stage of cancer as well as certain modifiable and non-modifiable risk factors.

Survival Rate by Stage

Colon cancer, often referred to collectively as colorectal cancer, is a progressive disease that advances in stages if left untreated. To predict the likely outcome (prognosis), doctors will stage the disease based on the characteristics of the tumor and the extent to which it has spread in the body.

For the purpose of estimating survival times, the disease is classified in three stages:

• Localized: Confined to the primary (original) tumor
• Regional: Cancer that has spread to lymph nodes
• Distant: Cancer that has spread to distant organs (also known as metastasis)

Based on data collected by the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program, researchers are able to estimate the percentage of people who will survive for a specific period of time following their diagnosis. This is referred to as the relative survival rate.

Typically, survival rates are described in five-year increments, known as the five-year survival rates. This is the proportion of people who will live for at least five years.

SEER survival estimates are based on all people with a particular type of cancer, irrespective of age, general health, cancer grade, or cancer cell type.

According to SEER estimates for 2020, the five-year survival rate for colorectal cancer in the United States breaks down as follows:

Survival Rate by Cancer Type

The majority of colon cancers involve a type of cancer known as adenocarcinoma, which originates in glands and glandular tissues. There are other less common types, some of which are more aggressive and harder to treat.

Adenocarcinoma

Adenocarcinoma accounts for around 95% of all colorectal cancers. Although SEER statistics are based largely on this type of cancer, there are rare subtypes known as mucinous adenocarcinoma and signet-ring cell carcinoma that are far more aggressive.

Mucinous adenocarcinoma originates in mucus-producing glands of the colon. Because the mucus can facilitate the spread of cancer cells, mucinous adenocarcinoma tends to be more invasive. Compared to typical adenocarcinoma, mucinous adenocarcinoma is associated with no less than a 20% reduction in overall survival times.  

Signet-ring cell carcinoma accounts for less than 1% of colon cancers and is differentiated by the appearance of its cells. This rare form of adenocarcinoma tends to be extremely aggressive, reflected by an overall five-year survival rate of 36.3%—roughly half of what is expected with typical adenocarcinoma.  

Sarcoma

Sarcomas are a broad category of cancers affecting connective tissues. The two types that most commonly affect the colon are gastrointestinal stromal tumors (GIST) and leiomyosarcoma.

GIST originates in a specific type of cell called an interstitial cell and can either be malignant or benign. Of the 30% that are malignant, the majority occur either in the stomach, small intestine, or rectum.  

GIST is associated with generally poorer outcomes, with an overall five-year survival rate of 46%.  

Leiomyosarcoma is a type of cancer affecting smooth muscles, including those of the colon and rectum. They are extremely rare, accounting for less than 0.1% of all colon cancers, and have an overall five-year survival rate of 43.8%. 

Lymphoma

Primary colorectal lymphoma is a type of non-Hodgkin lymphoma (NHL) affecting a type of white blood cell called a lymphocyte. Unlike Hodgkin lymphoma (HL), which typically progresses in an orderly fashion through the lymphatic system, NHL can develop in any part of the body, including the colon.

Primary colorectal lymphomas account for just 0.5% of all colorectal cancers and around 5% of all lymphomas. With that said, they tend to be associated with poorer outcomes, in part because they are difficult to diagnose. Studies suggest that the overall five-year survival rate for primary colorectal lymphoma is 56.4%.  

Melanoma

Melanoma is predominately known as a type of skin cancer but can affect any cell that produces the pigment known as melanin. These melanocytes can be found in the gastrointestinal tract and, in rare instances, can lead to primary colorectal melanoma.

Primary colorectal melanoma accounts for around 1% of all colorectal cancers and has by far the worst outcomes, with an overall five-year survival rate of just 20%.  

Colon Cancer Doctor Discussion Guide

Get our printable guide for your next doctor’s appointment to help you ask the right questions.

Factors That Influence Survival

The SEER survival estimates only paint a general picture of what to expect if you have colon cancer. Because the estimates are based on everyone with colon cancer, the statistics may not accurately reflect what is ahead for you as an individual.

There are several factors that influence survival times. Some are non-modifiable, meaning that you cannot change them, while others are modifiable and may potentially influence outcomes.

Surgical Resection

The surgical removal of the primary tumor, known as a resection, can increase the odds of remission and reduce the likelihood of disease progression. While surgery remains a primary form of colon cancer treatment, it is not appropriate for everyone.

Some cancers are inoperable and cannot be removed because of their location and/or the general health of the patient. Similarly, advanced metastatic cancers are rarely treated with resection because the procedure is not seen to improve survival times in most people.  

When surgery is indicated, the resection of the primary tumor can increase the overall five-year survival rate to 73.8% while reducing the risk of recurrence to just 6.4%.

In people with inoperable colon cancer, a minimally invasive approach called stereotactic radiation therapy (SBRT) offers a viable alternative to surgery. Studies suggest that people who undergo SBRT for stage 4 colorectal cancer have a four-year survival rate of around 43% when accompanied by chemotherapy.  

Age

Your age at the time of the colon cancer diagnosis can influence survival times as it can with other diseases. With a median age of diagnosis of 68 in men and 72 in women, older age already plays a central role in the onset of the disease. However, with each subsequent year, the risk of mortality increases.

According to a 2015 study in the Journal of Gastrointestinal Oncology, the overall five-year survival rate for people over 63 was 58.8%, dropping to 40.8% in those over 79—a drop of nearly 30%.

Performance Status

While age clearly plays a role in cancer survival times, not all older people are at equal risk. A person’s performance status (PS)—the ability to take care of oneself and perform everyday activities—also factors in.

PS is measured in several different ways. Chief among them is the Eastern Cooperative Oncology Group (ECOG) system, which classifies PS on a score of 0 (fully active) to 4 (fully disabled). Having a lower score generally means that you are less able to tolerate cancer treatments.

According to a 2017 study from Cleveland Clinic, a low, intermediate, and high PS score translates to a mortality rate of 8.1%, 11.2%, and 32.5%, respectively, within six months of the diagnosis.  

The researchers further concluded that PS plays a more central role in survival times than either age or co-occurring medical conditions.

Race

Race plays a central, albeit indirect, role in cancer survival rates due mainly to the lack of access to quality healthcare. This is a narrative that not only affects people with colon cancer but all other health conditions as well.

In the United States, the overall five-year survival rate for Whites with colon cancer is 65.4%. By contrast, Blacks have a five-year survival rate of 54.7%—a reduction of nearly 9%.

Contributing to this statistic is the higher rate of stage 4 colon cancer among Blacks, who are 20% more likely to be diagnosed after the tumor has metastasized compared to Whites.

Weight

Weight plays a role in the onset and progression of colon cancer as it does with many other diseases. Being overweight or obese not only contributes to the risk of the disease but can also influence outcomes after the tumor has been treated. This is especially true in women.

According to a 2013 study in the British Journal of Cancer, women with overweight or obesity have almost twice the risk of dying from colon cancer compared with women of normal weight.

Although the cause of this is poorly understood, having a high body mass index (BMI) increases the risk of insulin resistance, chronic inflammation, and impaired hormone function. Each of these is independently linked to both the onset and progression of colon cancer.

BMI is a dated, flawed measure. It does not take into account factors such as body composition, ethnicity, sex, race, and age.
Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.

Routine exercise may improve colon cancer survival, with some studies reporting anywhere from a 40% to 70% reduction in post-treatment mortality compared to people who engage in no exercise.

Smoking

Smoking affects all cancers, and colon cancer is no exception. Cigarette smoke not only induces chronic inflammation but also causes oxidative damage to DNA. These factors not only contribute to the onset of the disease but appear to increase the risk of colon cancer recurrence.

A 2015 review in the Annals of Oncology found that smoking after a colon cancer diagnosis increases the 60-day risk of death by 49% or more compared to never-smokers.

Not surprisingly, smoking cessation was linked to a 78% improvement in survival times compared to people who did not quit.

A Word From Verywell

It can be distressing to be diagnosed with colon cancer and even more distressing to be faced with the survival statistics. Whatever the stage of your cancer, it is important to remember that the statistics are based on everyone with the disease, regardless of their age, health, and other risk factors.

Many people live well beyond their initial prognosis. With newer, improved diagnostics and treatments, those gains are likely to increase. So, rather than focusing on survival times, focus on the factors you can change and keep appraised of the latest treatments and treatment approaches.

By working with your oncologist and become an “expert” on your disease, you are more likely to reap the benefits of treatment by making informed choices.

Frequently Asked Questions

How long can you live with colon cancer?

You can live a long, full life even if you have had colon cancer. In fact, it’s possible that medical treatment can entirely remove the cancer. Some people may have their colon cancer reappear, which is why cancer survivors are recommended to visit their doctor regularly after treatment is finished.

What is signet ring cell carcinoma?

Signet ring cell carcinoma is a type of cancer that causes a tumor to form in the breast, colon, gallbladder, pancreas, stomach, or urinary bladder. However, about 90% of people see it start in the stomach. One study on signet ring cell carcinoma found that it had a much greater survival rate in people who saw it originate in the stomach, compared to those who had it start in other areas of the body, like the pancreas or gallbladder.

21 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.

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By James Myhre & Dennis Sifris, MD
Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator.

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