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Journal of the National Cancer Institute, Vol. 98, No. 9, May 3, 2006 The impact of adjuvant therapy on cancer survival is one of our most important recent achievements in medical oncology. This milestone has been accomplished through the use of clinical trials especially among patients with breast and colon cancer. The annual odds of death from breast cancer alone among patients in these trials has decreased by up to 28%, depending on the criteria used for patient enrollment, the types of treatment given, and the characteristics of the tumors themselves ( 1 ) . Similar, but less well-defi ned, results have been reported for colon cancer ( 2 – 5 ) . Randomized clinical trials provide us with the strongest evidence of effi cacy for adjuvant cancer treatments. Observational studies such as that of Dobie et al. ( 6 ) in this issue of the Journal provide information on the long-term effectiveness of adjuvant treatments among a population-based sample.They indicate which factors predict the receipt of appropriate treatment, long-term overall and cancer-specifi c survival, and the adverse events that may accompany such therapy. The Surveillance, Epidemiology, and End-results (SEER) database was developed by combining regional cancer registries. Thanks to the work of Potosky et al. ( 7 ) , both the SEER and Medicare databases were linked in 1993. Now researchers have been provided with the tools to not only assess the use of surgical and radiation treatments among elderly cancer patients but also measure the use of adjuvant chemotherapy and the factors that predict whether it is given ( 7 – 9 ) . Today, SEER collects information from 14 population-based and three supplemental cancer registries covering 26% of the U.S. population, including many belonging to minority groups and to underserved groups ( 6 ) . Using 1992 – 1996 SEER program data linked to 1991 – 1998 Medicare claims, Dobie et al. ( 6 ) set out to examine the completion rate of adjuvant chemotherapy for colon cancer and its consequences in this elderly population. The number of patients who fulfi lled study criteria for analyzable data was 5778 of a total of 9796 patients who were identifi ed as being aged 66 years or older and had primary stage III colon cancer diagnosed between January 1, 1992, and December 31, 1996. The fi ndings are worthy of comment and should add to the education of medical oncologists and other physicians who participate in the management of patients undergoing curative resections for colon cancer. The effects of sex, age, factors related to social support (e.g., marital status), and ethnicity on completion rates are particularly noteworthy. Tumor characteristics, annual household income, and SEER region were not statistically independent predictors of adjuvant chemotherapy completion. Before commenting on the fi ndings, however, we want to expand on the historical perspective of this adjuvant chemotherapy period selected by the investigators. In 1990, Intergroup investigators ( 10 ) confi rmed the results of a smaller Mayo Clinic – initiated randomized study ( 11 ) that provided evidence for the value of a 1-year treatment with 5fl uorouracil (5FU) and levamisole as adjuvant chemotherapy for colon cancer. The importance of these fi ndings after more than two decades of negative 5FU adjuvant studies was underscored Completion Rates of Adjuvant Chemotherapy for Colon Cancer: A Historical Perspective