Colorectal cancer survival in Mexico: Leveraging a national health insurance database

• Published in: Cancer epidemiology 2025-02, Vol.94, p.102698, Article 102698
• Main Authors: Lozano-Esparza, Susana, Sánchez-Blas, Hugo Rodrigo, Huitzil-Meléndez, Fidel David, Meneses-Medina, Mónica Isabel, Van Loon, Katherine, Potter, Michael B., Mohar, Alejandro, Lajous, Martin
• Format: Article
• Language: English
• Subjects: Colorectal cancer; Mexico; Mortality; Young-onset
• ISSN: 1877-7821; 1877-783X; 1877-783X
• DOI: 10.1016/j.canep.2024.102698

We estimated the 5-year overall, age at diagnosis- and stage-specific colorectal cancer survival in patients treated through their coverage with Seguro Popular. We conducted a retrospective study using a dataset that included 1418 colorectal cancer patients covered by Seguro Popular (Mexico’s public health insurance system covering 60 % of the population) between 2013 and 2016. Deaths were identified using the Epidemiologic Death Statistics Subsystem registry, with a specialized algorithm for record linkage. The Kaplan-Meier method was used to estimate overall survival curves and the proportion of patients alive at various follow-up time points. We compared survival curves across subgroups using the log-rank test. In this study the average age at diagnosis was 56 years with 31.9 % of patients diagnosed before the age of 50. Most cases (78.1 %) were diagnosed in advanced stages (i.e., III and IV), with nearly half of the cases originating in the rectum. The overall 5-year survival was 50 %, with higher survival (74 %) for patients with stage I-II and lower survival for those with stage III (58 %) and IV (33 %). While age at diagnosis was not associated with survival for early-stage colorectal cancer, younger patients with metastatic disease had a worse prognosis compared to older patients. The 5-year overall colorectal cancer survival was 50 %, with variation by clinical stage. Almost 80 % of the population was diagnosed with advanced stages, underscoring the need for screening programs. Younger patients with metastatic disease exhibited a worse prognosis, highlighting the need for targeted interventions. •Advanced colorectal cancer stages at diagnosis is common among a cohort of Mexican patients.•Seguro Popular data reveals that only half of colorectal cancer patients survived past five years.•Rising colorectal mortality among Mexicans under 50 highlights early screening need.