Colon cancer as a subsequent malignant neoplasm in young adults

Abstract

BACKGROUND: The incidence of colon cancer (CC) is rising in younger adults and can occur de novo or in patients previously treated for another cancer. To the authors' knowledge, the impact on survival of CC occurring as a subsequent malignant neoplasm (SMN) has not been described for younger patients, which the authors anticipate to be lower with SMNs than that of primary CC. METHODS: Patients aged <50 years with CC in the 2004 through 2014 National Cancer Data Base were identified. Patients were stratified by primary or subsequent occurrence. The impact of SMN status on overall survival (OS) was evaluated. RESULTS: Of 41,915 patients, 2852 (6.8%) had colon SMNs. More patients with colon SMNs were aged 40 to 49 years compared with patients with primary CC (83% vs 77%; P < .001). Patients with colon SMNs presented with earlier clinical and pathological T, N, and M classifications (all P < .001). Colon SMNs more commonly occurred in the right colon, whereas primary CC was found to have a higher prevalence in the sigmoid colon (P < .001). Patients with colon SMNs more frequently underwent total colectomy (17% vs 5%; P < .001), but received less chemotherapy (53% vs 65%; P < .001). When adjusted for demographic, tumor, and treatment characteristics, SMN status was associated with a 23% decreased OS compared with primary CC (95% CI, 1.14-1.31; P < .001). Chemotherapy offered a 33% improvement in OS (95% CI, 0.56-0.8; P < .001). CONCLUSIONS: Colon SMNs in younger patients present at an earlier stage and are treated more aggressively surgically compared with primary CCs. Patients with SMNs of the colon have decreased survival, although chemotherapy offers a survival advantage. Further investigation is warranted to determine whether these disparities are due to the effects of cancer treatment or differences in tumor biology. Cancer 2019;125:3749-3754.

Luteolin induces pyroptosis in HT-29 cells by activating the Caspase1/Gasdermin D signalling pathway

“…It is one of the most common malignant tumours, and its incidence and mortality rates rank among the top five of cancers worldwide ( Siegel et al, 2017 ). Furthermore, the population of people with colon cancer appears to be getting younger ( Teng et al, 2019 ). Surgical treatment is currently the primary treatment for early colon cancer; however, because colon cancer is difficult to detect in the early stage, improved approaches for the treatment of colon cancer via combination therapy or chemotherapy have emerged ( Cappell, 2008 ).…”

BHLHE41 Overexpression Alleviates the Malignant Behavior of Colon Cancer Cells Induced by Hypoxia via Modulating HIF-1α/EMT Pathway

“…According to statistics from the World Cancer Database in 2018, the incidence of CC has exceeded 1 million, and the mortality rate in developed countries was as high as 33% [ 2 ]. The occurrence of CC has always been considered as a common disease in middle-aged and elderly people, while currently, CC incidence is on the rise among young adults, which is related to human dietary structure, exercise, bad living habits, and other risk factors [ 3 ]. At present, the treatment of CC is mainly surgical resection supplemented by radiotherapy and chemotherapy, gene therapy, and molecular targeted therapy, while the risk of the high postoperative recurrence rate still impedes the prognosis of CC patients [ 4 – 6 ].…”

CUL4B increases platinum‐based drug resistance in colorectal cancer through EMT: A study in its mechanism

“…Some of its fatality can be attributed to its strong ties to genetics and environmental effects. In the past years, incidence and mortality of CRC has been steadily decreasing, partly accreditable to the health‐conscious society's increased tumour surveillance and better treatment 2 . The typical CRC begins as an adenomatous polyp in the normal colonic epithelium as it accumulates mutations in known targetable oncogenes, tumour suppressor genes, and genes related to DNA repair 3 .…”