Comparison of the Prognosis between Early-Onset and Later-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis

Li, Xinxing; Jin, Taojun; Ji, Jianmei; Li, Jue; Yin, Xiaomao; Xu, Kai; Wang, Wenqiang; Zhang, Wei; Xu, Xiaowen; Gong, Bin; Hu, Zhiqian

doi:10.2139/ssrn.4287469

Cited by 2 publications

(3 citation statements)

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“…While a recent metanalysis found that there was no material difference in cancer specific survival in EOCRC compared to older patients [7], strategies are needed to help improve outcomes in EOCRC. One issue affecting EOCRC internationally is delay to diagnosis [5,18], with delays contributing to more advanced stage at diagnosis, and resulting in poorer outcomes [19].…”

Section: Discussionmentioning

confidence: 99%

“…The clinical characteristics of EOCRC can differ from late-onset colorectal cancer (LOCRC, diagnosed over 50 years of age), with EOCRC more likely to be left sided (sigmoid and rectum), have higher rates of mucinous or signet ring histology, be poorly differentiated, and present with advanced (stage 3 or 4) disease [5,6]. Despite these differences, a recent meta-analysis found no overall difference in cancer specific survival between early-onset and late-onset disease [7].…”

Section: Introductionmentioning

confidence: 99%

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The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000–2020

Waddell,

Pearson,

McCombie

et al. 2024

BMC Cancer

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Background The incidence of early-onset colorectal cancer (EOCRC), diagnosed before age 50, has been rising in many countries in the past few decades. This study aims to evaluate this trend in Aotearoa New Zealand and assess its impact on Māori. Methods Crude incidence and age-standardized incidence of colorectal cancer (CRC) was analyzed from all new cases from the Aotearoa New Zealand national cancer registry for the period 2000–2020. Trends were estimated by sex, ethnicity, age group and location of cancer and projections made to 2040. Results Between 2000 and 2020, there were a total of 56,761 cases of CRC diagnosed in Aotearoa New Zealand, 3,702 of these being EOCRC, with age-standardized incidence decreasing significantly (P = 8.2 × 10− 80) from 61.0 to 47.3 cases per 100,000. EOCRC incidence increased on average by 26% per decade (incidence rate ratio (IRR) 1.26, p = < 0.0001) at all sites (proximal colon, distal colon and rectum), while the incidence in those aged 50–79 years decreased on average by 18% per decade (IRR 0.82, p = < 0.0005), again across all sites. There was no significant average change in CRC incidence in those over 80 years. In Māori, there was no significant change in age-standardized incidence. There was however a significant increase in crude incidence rates (IRR 1.28, p = < 0.0005) driven by significant increases in EOCRC (IRR1.36, p = < 0.0005). By 2040, we predict the incidence of EOCRC will have risen from 8.00 to 14.9 per 100,000 (6.33 to 10.00 per 100,000 in Māori). However, due to the aging population an estimated 43.0% of all CRC cases will be diagnosed in those over 80 years of age (45.9% over 70 years of age in Māori). Conclusion The age-standardized incidence of CRC from 2000 to 2020 decreased in Aotearoa New Zealand, but not for Māori. The incidence of EOCRC over the same period continues to rise, and at a faster rate in Māori. However, with the ageing of the population in Aotearoa New Zealand, and for Māori, CRC in the elderly will continue to dominate case numbers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000–2020

Waddell,

Pearson,

McCombie

et al. 2024

BMC Cancer

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“…CRD42022334697). 22 This systematic review and meta-analysis followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 23 and Meta-analyses of Observational Studies in Epidemiology (MOOSE) reporting guidelines. 24…”

Section: Review Registration and Approachmentioning

confidence: 99%

Comparison of the short‐ and long‐term prognosis of early‐onset colorectal cancer compared with later‐onset colorectal cancer: A systematic review and meta‐analysis

Jin

et al. 2023

Health Science Reports

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Background and Aims: The annual incidence of early-onset colorectal cancer (EOCRC) is increasing at an alarming rate. The prognosis of EOCRC remains controversial, and whether the early onset is a risk factor for colorectal cancer remains unclear.Methods: We searched four electronic bibliographic databases from database inception to April 25, 2022 for studies that included both early-and later-onset patients and performed a prognostic analysis. Random-effects models were used to summarize the prognostic information extracted by the investigators, including overall survival (OS), cancer-special survival (CSS), and disease-free survival (DFS).Network meta-analysis (NMA) was used to compare patients' long-term prognoses in different age subgroups.Results: After 694 reports were screened, 13 studies were included in the final analysis, with a total of 448,781 CRC cases. In the meta-analysis of the 5-year OS, EOCRC had a better prognosis compared to LOCRC (hazard ratio [HR] 0.87, 95% confidence interval [CI], 0.74-0.99; relative risk [RR] 0.83, 95% CI, 0.78-0.89). No difference in prognosis was found between the two groups in terms of 5-year CSS (RR 0.99, 95% CI, 0.93-1.05), 5-year DFS (RR 0.90, 95% CI, 0.74-1.09), and shortterm OS. In the NMA, patients aged <30 years had the worst outcome (surface under the cumulative ranking curve [SUCRA], 15.8%) in 5-year OS; consistent results were observed in the analysis of 5-year CSS (<30 years, SUCRA 4.5%), but the difference was not statistically significant. Conclusion:Although patients with early-onset CRC had better OS than those with later-onset CRC, there was no difference in the CSS. Meanwhile, the trend for survival was worse in younger patients, especially in those ages 18-29 years. Thus, more attention should be paid to early diagnosis and treatment of EOCRC.

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Comparison of the Prognosis between Early-Onset and Later-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis

Cited by 2 publications

References 0 publications

The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000–2020

The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000–2020

Comparison of the short‐ and long‐term prognosis of early‐onset colorectal cancer compared with later‐onset colorectal cancer: A systematic review and meta‐analysis

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