Care for a veteran with a new diagnosis of colorectal cancer in 2025 reflects a treatment algorithm that is more precise, more individualized, and more effective than anything available 10 years ago.
A veteran sits across from his or her VA oncologist with a new diagnosis of metastatic colorectal cancer. Ten years ago, the conversation followed a well-traveled path: Treatment included a chemotherapy doublet, maybe with a biologic. CRC was no less molecularly complex, but fewer biomarkers had been identified or targeted.
Colorectal cancer (CRC) is, at first glance, a public health success story. Incidence among adults over 50 has fallen nearly 50% since the mid-1980s, driven by the steady expansion of colonoscopy screening and the removal polyps before they can progress. Mortality rates in the over-50 population similarly have declined.
In the mapping of colorectal cancer for much of the past three decades the dominant question has been “which molecular features of this tumor matter?” Now, the question shifts to “how can veterans benefit?”