Disease Characteristics, Clinical Management, and Outcomes of Young Patients With Colon Cancer: A Population-based Study

Rodríguez, Laura; Brennan, Kelly; Karim, Safiya; Nanji, Sulaiman; Patel, Sunil V.; Booth, Christopher M.

doi:10.1016/j.clcc.2018.06.007

Cited by 52 publications

(59 citation statements)

References 22 publications

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“…In our cohort, we showed that CCSM increased with advanced age, which were in accordance with a previous population-based analysis demonstrating that older age was associated with decreased survival in early-stage disease [8]. Likewise, other studies have shown similar results [16,17]. It has been reported that young patients presented poorer pathological features and advanced T stage compared with older patients, but were associated with a better OS and less CCSM [18,19].…”

Section: Discussionsupporting

confidence: 91%

Association of age and cause-special mortality in patients with stage I/ II colon cancer: A population-based competing risk analysis

et al. 2020

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This study aimed to determine the probability and prognostic factors of colon cancer-specific mortality (CCSM) and noncancer-specific mortality (NCSM) for patients with stage I/II colon cancer and evaluate the association of age on cause-specific mortality. Materials and methods From Surveillance, Epidemiology, and End Results (SEER) database, we identified 33152 patients with stage I/II colon cancer undergoing surgery between 2004 and 2011. The cumulative incidence of CCSM and NCSM was calculated, and competing risk analysis was performed to investigate prognostic factors for cause-specific mortality. Results In patients <50, 50-75, and >75 years of age, 5-year cumulative incidence of CCSM was 5.7%, 7.8%, and 16.1%, respectively (overall, 10.6%); 5-year cumulative incidence of NCSM was 2.2%, 7.1%, and 26.9%, respectively (overall, 13.8%). The probability of CCSM and NCSM increased with advanced age. The 5-year cumulative incidence of CCSM was higher than NCSM in patients <50 years of age, whereas lower in patients >75 years of age. The probability of CCSM and NCSM was similar in patients 50-75 years of age. Competing-risk multivariable analysis demonstrated that increasing age was a strong predictor of CCSM (per year increase, SHR 1.03,95% confidence interval [CI]: 1.03-1.04). Age was most predictive of NCSM: (per year increase, SHR 1.08, 95% CI: 1.08-1.08). Conclusion Age was significantly associated with an increased cumulative incidence of CCSM and NCSM of patients with stage I/II colon cancer underwent surgery. NCSM was a significant competing event and should be adequately considered when performing survival analysis.

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Section: Discussionsupporting

confidence: 91%

Association of age and cause-special mortality in patients with stage I/ II colon cancer: A population-based competing risk analysis

et al. 2020

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“…It is important to note that different studies use different age cutoffs (age < 55 in some and < 40 in others). 3,[7][8][9] The reason for this increase in CRC in young individuals is not entirely clear. Most of these cases are sporadic rather than hereditary.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies also reported that young patients with CRC present with later stage of disease. 22,23 Recently Rodriguez et al 9 investigated 6775 colon cancer patients from the Ontario cancer registry and demonstrated that a greater proportion of younger patients (88%) had advanced disease compared to older patients (79%) in their cohort. A study in 3318 CRC patients from Australia also reported that a greater proportion of patients < 40 (80.4%) presented with metastatic disease compared to patients aged 40 (64.4%).…”

Section: Discussionmentioning

confidence: 99%

Rising Proportion of Young Individuals With Rectal and Colon Cancer

Kasi

Shahjehan

Cochuyt

et al. 2019

Clinical Colorectal Cancer

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We noticed an increased number of patients diagnosed with colorectal cancer (CRC) in their 20s, 30s, and 40s. We analyzed all CRC patients aged < 50 at our institutions from 1972 to 2017 and found increasing trends as well as a propensity for more distal location-findings that are hypothesis generating, given the embryologic origin of these tumors. This finding may have implications for screening guidelines. Background: Recent trends have identified increasing number of young individuals with rectal and colon cancers. These individuals, who are younger than 50 years old, in most instances would not meet screening guidelines. We aimed to report the characteristics and trend of the rising proportion of young individuals being diagnosed with rectal and colon cancers at our institutions. Patients and Methods: This study included 3381 rectal and colon cancer patients from the Mayo Clinic cancer registry from 1972 to 2017 who were diagnosed with rectal or colon cancer and who were < 50 years old. Patient and cancer characteristics are described. The Cochran-Armitage trend test was used to see if the change in percentage diagnosed at age < 50 years had a significant trend over the years. A linear regression model was fit to estimate the percentage change per year when the trend was approximately linear. Results: The percentage of patients diagnosed with rectal or colon cancer in different age categories over the years showed a rising trend for individuals aged < 50. Most of these tumors were distal (rectum, left-sided colon, and rightsided colon were 49.8%, 28.8%, and 21.4%, respectively). This was more so for patients < 50 diagnosed with rectal cancer, which showed a linear increase at a rate of 0.26% per year (P < .001). Conclusion: Our study affirms the rising proportion of colorectal cancers found in young individuals, with a linear ongoing rise of rectal cancers in particular. This may have implications for the current screening recommendations for colorectal cancers, which are already being revised.

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“…We systematically retrieved 37 articles describing the prognosis of EO‐CRC compared with older patients (Abdelsattar et al ., ; Blanke et al ., ; Boyce et al ., ; Chandrasinghe et al ., ; Chou et al ., , ; Damodaran and Seshadri, ; Fu et al ., ; Fu et al ., ; Haleshappa et al ., ; Hawk et al ., ; Hubbard et al ., ; Josifovski et al ., ; Khan et al ., ; Kim et al ., ; Kneuertz et al ., ; Kolarich et al ., ; Li et al ., ; Lieu et al ., ; Manjelievskaia et al ., ; McMillan and McArdle, ; Murata et al ., ; O'Connell et al ., ; Orsini et al ., ; Pokharkar et al ., ; Quah et al ., ; Rho et al ., ; Rodriguez et al ., ; Shen et al ., ; Shida et al ., ; Sultan et al ., ; Vatandoust et al ., ; Wang et al ., ,; Yang et al ., ; You et al ., ; Zhao et al ., ). EO‐CRC survival data are conflicting.…”

Section: Methodsmentioning

confidence: 99%

“…EO‐CRC survival data are conflicting. Some studies indicate a poorer prognosis (Bleyer et al ., ; Khan et al ., ; Lieu et al ., ; McMillan and McArdle, ; O'Connell et al ., ; Shida et al ., ; Sultan et al ., ), whereas others support a comparable or even better prognosis in comparison with older patients (Blanke et al ., ; Hubbard et al ., ; Kneuertz et al ., ; Kolarich et al ., ; McMillan and McArdle, ; O'Connell et al ., ; Quah et al ., ; Rodriguez et al ., ; Vatandoust et al ., ; Wang et al ., ; You et al ., ; Table ). From 1973 to 2005, adult CRC survival outcome improved, whereas child and adolescent CRC survival have not (Sultan et al ., ).…”

Section: Methodsmentioning

confidence: 99%

Early‐onset colorectal cancer in young individuals

et al. 2018

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Treatment of young adults with colorectal cancer (CRC) represents an unmet clinical need, especially as diagnosis in this population might lead to the greatest loss of years of life. Since 1994, CRC incidence in individuals younger than 50 years has been increasing by 2% per year. The surge in CRC incidence in young adults is particularly alarming as the overall CRC frequency has been decreasing. Early‐onset CRC are characterized by a more advanced stage at diagnosis, poorer cell differentiation, higher prevalence of signet ring cell histology, and left colon‐sided location of the primary tumor. Among EO‐CRC, approximately 30% of patients are affected by tumors harboring mutations causing hereditary cancer predisposing syndromes, and 20% have familial CRC. Most notably, the remaining 50% of EO‐CRC patients have neither hereditary syndromes nor familial CRC, thus representing a formidable challenge for research. In this review article we summarize epidemiology, clinical and molecular features, heredity and outcome of treatments of EO‐CRC, and provide considerations for future perspectives.

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Disease Characteristics, Clinical Management, and Outcomes of Young Patients With Colon Cancer: A Population-based Study

Cited by 52 publications

References 22 publications

Association of age and cause-special mortality in patients with stage I/ II colon cancer: A population-based competing risk analysis

Association of age and cause-special mortality in patients with stage I/ II colon cancer: A population-based competing risk analysis

Rising Proportion of Young Individuals With Rectal and Colon Cancer

Early‐onset colorectal cancer in young individuals

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