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Younger CRC patients increased mortality associated with late diagnosis

Mon, 06/21/2021 - 12:22
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There is a survival benefit associated with early-onset colorectal cancer (CRC) compared with later-onset CRC reinforcing the importance of early CRC detection in the younger population, according to researchers at Yale School of Public Health in New Haven, CT.The outcomes were featured in the paper, ‘Analysis of Survival Among Adults With Early-Onset Colorectal Cancer in the National Cancer Database', published in JAMA Open Network.

In the study, the researchers sought to characterise the overall survival for individuals with early-onset CRC, compared with survival rates associated with CRC diagnosed at older ages. Using data from the National Cancer Database, the researchers included patients diagnosed at ages 51-55 years were selected as the reference group and defined as later-onset CRC. Early-onset CRC was defined as age younger than 50 years at diagnosis.

In total, 769,871 patients with CRC were included in the study (377,890 [49.1%] women; 636,791 white [82.7%]). The researchers report that 353,989 individuals (46.0%) died with 102,168 individuals (13.3%) had early-onset CRC and 78,812 individuals (10.2%) had later-onset CRC. Individuals with early-onset CRC, compared with individuals diagnosed with CRC at ages 51 through 55 years, were more likely to be female (48 345 [47.3%] women vs 34,546 [43.8%] women; p<0.001), be diagnosed at an advanced stage (28,378 individuals [27.8%] vs 18,967 individuals [24.1%] with stage IV cancer; p<0.001), have rectal tumours (29,983 [29.3%] vs 22,643 [28.7%]; p=0.004), and use cancer treatment (ie, radiation: 25,277 [24.7%] vs 17,382 [22.1%]; p<0.001; chemotherapy: 69,451 [68.0%] vs 46,673 [59.2%]; p<0.001; immunotherapy: 3,356 [3.3%] vs 2,151 [2.7%]; p<0.001; and surgical treatment: 88,266 [86.4%] vs 68,439 [86.8%]; p=0.005) and were less likely to have comorbidities (eg, 90,389 [88.5%] vs 64,024 [81.2%], p<0.001).

“Our finding of a survival advantage associated with early-onset CRC among younger individuals should be interpreted cautiously, given that the advantage had a small magnitude and was heterogeneous by age and stage,” the author’s concluded. “Further study is needed to understand the underlying heterogeneity of survival by age and stage among individuals with early-onset CRC.”

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