Clinicopathological Features and Survival Outcomes of Colorectal Cancer in Young Versus Elderly

Wang, Rui; Wang, Mo-Jin; Ping, Jie

doi:10.1097/md.0000000000001402

Cited by 81 publications

(66 citation statements)

References 20 publications

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“…Looking at the age at diagnosis, patients with CRC below the age of 50 years had the most favorable overall and stage-adjusted survival, although they had the highest proportion of stage III and stage IV cancers. Better or equal prognosis of younger than older patients, even when presenting at later stages and with more aggressive tumors, has been previously reported [41][42][43].…”

Section: Discussion In the Context Of The Literaturementioning

confidence: 73%

Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study

et al. 2018

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Socioeconomic inequalities in cancer stage at diagnosis and survival are important public health issues. This study investigates the association between socioeconomic position (SEP) and colorectal cancer (CRC) stage at diagnosis and survival in Switzerland, a European country with highest level of medical facilities and life expectancy. We used population‐based CRC data from seven Swiss cantonal cancer registries 2001–2008 (N = 10,088) linked to the Swiss National Cohort (SNC). Follow‐up information was available until the end of 2013. SEP was estimated based on education. The association between cancer stage and SEP was assessed using logistic regression models including cancer localization (colon/rectum), sex, age, civil status, urbanity of residence, language region, and nationality (Swiss/non‐Swiss). Survival was analyzed using competing risk regressions reporting subhazard ratios (SHRs) for the risk of dying due to CRC. We observed a social gradient for later stage CRC with adjusted odds ratios (ORs) of 1.11 (95% CI: 0.97–1.19) and 1.28 (95% CI: 1.08–1.50) for middle and low SEP compared to high SEP. Further, single compared to married people had elevated odds of being diagnosed at later stages. Survival was lower in patients with CRC with low SEP in the unadjusted model (SHR: 1.18, 95% CI: 1.07–1.30). After adjustment for stage at diagnosis and further sociodemographic characteristics, significant survival inequalities by SEP disappeared but remained for non‐Swiss compared to Swiss citizens and for patients living in nonurban areas compared to their urban counterparts. Swiss public health strategies should facilitate equal access to CRC screening and optimal CRC care for all social groups and in all regions of Switzerland.

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Section: Discussion In the Context Of The Literaturementioning

confidence: 73%

Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study

et al. 2018

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“…Conversely, some smaller studies have not identified any age-related differences in histology or stage of disease between different age groups [17,30]. Some authors have suggested that the higher rate of advanced disease seen in the younger patient groups could be attributed to delayed diagnosis because: (1) younger patients are more likely to dismiss red-flag bowel symptoms and (2) physicians are less likely to refer young patients for endoscopic investigations, attributing their symptoms as benign [11,22,31]. Dozois et al [32] suggested maintaining a high index of suspicion when assessing young patients with abdominal symptoms because the majority of patients with CRC in their study were symptomatic at the time of presentation.…”

Section: Discussionmentioning

confidence: 99%

The association of age with the clinicopathological characteristics and prognosis of colorectal cancer: a UK single‐centre retrospective study

Anele

Askari

Navaratne³

et al. 2019

Colorectal Disease

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Introduction Colorectal cancer (CRC) is uncommon in patients under the age of 40 years and its association with poor histological features and survival is uncertain. This study aimed to evaluate age‐related differences in clinicopathological features and prognosis in patients diagnosed with CRC. Method A single‐centre retrospective review of all patients diagnosed with CRC between 2004 and 2013 was performed. Patients were stratified into three age groups: (1) 18–40 years, (2) 41–60 years and (3)> 60 years. Clinicopathological characteristics and outcomes were compared between the three groups. Results A total of 1328 patients were included, of whom 57.2% were men. There were 28 (2.1%) patients in group 1, 287 (21.6%) in group 2 and 1013 (76.3%) in group 3. Group 1 had the highest proportion of rectal tumours (57.1% in group 1, 50.2% in group 2 and 31.9% in group 3; P < 0.001). Tumour histology and disease stage were comparable between the groups. Group 1 had significantly worse disease‐free survival (DFS) than the two older groups (44%, 78% and 77%, respectively; P = 0.022). Multivariate analysis demonstrated that age was not an independent prognostic factor whereas Stage III disease [hazard ratio (HR) 4.42; 95% CI 2.81–6.94; P < 0.001] and neoadjuvant chemotherapy (HR 1.65; 95% CI 1.06–2.58; P = 0.026) were associated with increased risk of recurrence. Conclusion Patients under the age of 40 are more likely to present with rectal cancer and have comparable histological features than the older groups. Despite higher rates of adjuvant and neoadjuvant treatment, the young group were found to have worse DFS.

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“…Table IV shows the 5-year observed and relative survival by age group (15-34, 35-44, 45-54, 55-64, 65-74, and 75+) for all the major cancer sites. Relatively higher survival rates were observed in younger patients (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) compared with older patients (65-74, 75+), particularly for sites including the stomach, lung, pancreas, B and CNS, blood (NHL) and cervix. Cancer of the oesophagus, female breast and bladder had higher survival in middle-aged groups (45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)…”

Section: Resultsmentioning

confidence: 99%

“…the prognosis of cancer, but these included only a short time period (13,14), or site-specific survival from population based data (15)(16)(17). For providing a long-term assessment of population-based cancer data, this paper provides a systematic analysis of cancer survival for the period of 1972-2011 in Qidong, China.…”

Section: Cancer Survival In Qidong Between 1972 and 2011: A Populatiomentioning

confidence: 99%

Cancer survival in Qidong between 1972 and 2011: A population-based analysis

Chen

Zhu

Zhang

et al. 2017

Molecular and Clinical Oncology

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Abstract. Population-based cancer survival is an improved index for evaluating the overall efficiency of cancer health services in a given region. The current study analysed the observed survival and relative survival of leading cancer sites from a population-based cancer registry between 1972 and 2011 in Qidong, China. A total of 92,780 incident cases with cancer were registered and followed-up for survival status. The main sites of the cancer types, based on the rank order of incidence, were the liver, stomach, lung, colon and rectum, oesophagus, breast, pancreas, leukaemia, brain and central nervous system (B and CNS), bladder, blood [non-Hodgkin's lymphoma (NHL)] and cervix. For all malignancies combined, the 5-year observed survival was 13.18% and the relative survival was 15.80%. Females had higher observed survival and relative survival (19.32 and 22.71%, respectively) compared with males (9.63 and 11.68%, respectively). The cancer sites with the highest five-year relative survival rates were the female breast, bladder, cervix and colon and rectum; followed by NHL, stomach, B and CNS cancer and leukaemia. The poorest survival rates were cancers of oesophagus, lung, pancreas and liver. Higher survival rates were observed in younger patients compared with older patients. Cancers of the oesophagus, female breast and bladder were associated with higher survival in middle-aged groups. Improved survival rates in the most recent two 5-year calendar periods were identified for stomach, lung, colon and rectum, oesophagus, female breast and bladder cancer, as well as leukaemia and NHL. The observations of the current study provide the opportunity for evaluation of the survival outcomes of frequent cancer sites that reflects the changes and improvement in a rural area in China.

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Clinicopathological Features and Survival Outcomes of Colorectal Cancer in Young Versus Elderly

Cited by 81 publications

References 20 publications

Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study

Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study

The association of age with the clinicopathological characteristics and prognosis of colorectal cancer: a UK single‐centre retrospective study

Cancer survival in Qidong between 1972 and 2011: A population-based analysis

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