Is colorectal cancer a more aggressive disease in young patients? A population-based study from the Czech Republic

Kocián, Petr; Svobodová, Ivana; Krejčí, Denisa; Bláha, M.; Gürlich, R; Dušek, Ladislav; Hoch, J; Whitley, Adam

doi:10.1016/j.canep.2019.101621

Cited by 18 publications

(15 citation statements)

References 30 publications

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“…The latest study, presented herein, revealed that early-onset CRC patients presenting left-sided tumors were slightly more prevalent than late-onset CRC patients, although this difference was not significant. This finding is supported by a similar study from the Czech Republic that showed a shift in tumor location to the proximal colon among young compared with elderly patients, with tumors on the left side identified in 25.1% of young patients and in 22.3% of older patients, in which the rectum was the most common site of the tumors[ 26 ]. A meta-analysis conducted in North America among CRC patients aged < 50 years also showed that younger cases were less likely to present with right-sided primary tumors[ 27 ].…”

Section: Discussionsupporting

confidence: 67%

Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors

Makmun¹,

Simadibrata²,

Abdullah³

et al. 2021

WJCC

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BACKGROUND An increasing trend in colorectal cancer (CRC) occurring at younger ages has been observed worldwide, even though incidence is declining in the general population. Most currently available guidelines still recommend CRC screening for older populations, despite an alarming rise in early-onset CRC incidence. Risk stratification is necessary to further determine the population most at risk for early-onset CRC. However, epidemiological data on related clinical characteristics and potential risk factors, especially in developing countries, have not been widely reported. AIM To investigate the prevalence, demographics, clinicopathologic features, and associated factors of young-onset CRC patients in a tertiary hospital in Indonesia. METHODS Patients undergoing colonoscopy examination between 2008 and 2019, yielding a diagnosis of CRC were identified from medical records. The subjects were classified into two groups according to their age at diagnosis, namely early-onset (18-49 years old) and late-onset (≥ 50-years-old). Demographic data, characteristics, and risk factors of both onset age groups were evaluated using the chi-square and Fisher’s exact test. RESULTS Among 495 CRC patients confirmed by histopathology, 205 (41.4%) were classified as early-onset and 290 (58.6%) as late-onset. Most subjects in the early-onset CRC group were male (53.7%), with 89.8% displaying adenocarcinoma histopathology. A majority (78%) of the early-onset CRC patients had left-sided tumors, with the rectum (41%) and rectosigmoid (17.6%) being the most common sites. Abdominal pain was the most frequent symptom in the early-onset CRC patients (55.6%), which was significantly higher than that in the late-onset CRC patients (43.8%, P < 0.05). Early-onset CRC cases were more likely to be underweight (34.6% vs 20.0%, P < 0.001) compared to late-onset CRC cases. The proportion of subjects with suspected hereditary nonpolyposis colorectal cancer (HNPCC) was also higher in the early-onset CRC group than in the late-onset age group (9.3% vs 4.1%, P < 0.05). However, no difference was observed in the parental or family histories of CRC cases. CONCLUSION Early-onset CRC patients were more likely to have abdominal pain, underweight status, and HNPCC suspicion than late-onset CRC patients.

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Section: Discussionsupporting

confidence: 67%

Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors

Makmun¹,

Simadibrata²,

Abdullah³

et al. 2021

WJCC

View full text Add to dashboard Cite

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“…Some studies reported that young patients with CRC had a worse prognosis than older patients [22][23][24]. Some studies reported the opposite results [25,26], and another study demonstrated that age was not associated with the prognosis of CRC [27]. This controversy may be due to the limited sample sizes.…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Prognostic Nomograms based on Homogeneous and Heterogeneous Associated Factors for Predicting the Overall Survival of Colorectal Cancer Patients with Distant Metastases

Wang

Shan

zhang

et al. 2021

Preprint

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Background: To identify the heterogeneous and homogeneous prognostic factors associated with distant metastases in colorectal cancer (CRC) patients and then construct nomograms to predict prognosis.Methods: CRC patients registered in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2016 were included. Cox regression was used to analyse homogeneous and heterogeneous prognostic factors, and Kaplan-Meier analysis was used to estimate overall survival (OS). Predictive nomograms were constructed, and their performance was evaluated with C-indexes and calibration curves.Results: A total of 34933 patients with distant metastases were included. The median survival time of patients with liver metastases, lung metastases, bone metastases, and brain metastases were 12.00 months (95% CI: 11.71-12.29 months), 10.00 months (95% CI: 9.57-10.43 months), 5.00 months (95% CI: 4.47-5.53 months), and 3.00 months (95% CI: 2.31-3.70 months), respectively. Older age and no surgery were identified as homogeneous prognostic factors of the four types of metastases. Male sex, black race, unmarried status, uninsured status, primary CRC site, poor differentiation/grade, advanced N stage, T stage, high carcinoembryonic antigen (CEA) level and metastatic organ were heterogeneously associated with the prognosis of patients with distant metastases. The calibration curves and C-indexes exhibited good performance for predicting the OS of patients with distant metastases.Conclusion: CRC patients with distant metastases exhibited homogeneous and heterogeneous prognostic factors, all of which were associated with poor survival. The nomograms showed good accuracy and can be used as tools for clinicians to predict the prognosis of CRC patients with distant metastases.

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“…However, no statistically significant difference in cancer staging between the two age groups was evident, similar to a prior report. 128 This might reflect increased awareness of the disease among young patients and primary care physicians, better access to colonoscopy, and more widespread use of CT with improved quality. Also, the introduction of national health insurance in the middle of the study period (2014) made access to healthcare more accessible, increasing people’s concern for their health.…”

Section: Discussionmentioning

confidence: 99%

Analysing 11 years of incidence trends, clinicopathological characteristics, and forecasts of colorectal cancer in young and old patients: a retrospective cross-sectional study in an Indonesian national referral hospital

et al. 2022

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ObjectiveTo obtain annual incidence trends, understand clinicopathological characteristics, and forecast the future burden of colorectal cancer (CRC) in Indonesia.Design11-year retrospective cross-sectional study.SettingA national referral hospital in Jakarta, Indonesia.ParticipantsData from 1584 eligible cases were recorded for trends and forecasting analyses; 433 samples were analysed to determine clinicopathological differences between young (<50 years) and old (≥50 years) patients.MethodsTrend analyses were done using Joinpoint software, expressed in annual percentage change (APC), and a regression analysis was executed to generate a forecasting model. Patients’ characteristics were compared using χ2 or non-parametric tests.Main outcomesAnalysis of trends, forecasting model, and clinicopathological features between the age groups.ResultsA significant increase in APC was observed among old patients (+2.38%) for CRC cases. Colon cancer increased remarkably (+9.24%) among young patients; rectal cancer trends were either stable or declining. The trend for right-sided CRC increased in the general population (+6.52%) and old patients (+6.57%), while the trend for left-sided CRC was stable. These cases are expected to be a significant health burden within the next 10 years. Patients had a mean age of 53.17±13.94, 38.1% were young, and the sex ratio was 1.21. Prominent characteristics were left-sided CRC, tumour size ≥5 cm, exophytic growth, adenocarcinoma, histologically low grade, pT3, pN0, inadequately dissected lymph nodes (LNs), LN ratio <0.05, no distant metastasis, early-stage cancer, no lymphovascular invasion, and no perineural invasion (PNI). Distinct features between young and old patients were found in the histological subtype, number of dissected LN, and PNI of the tumour.ConclusionsEpidemiological trends and forecasting analyses of CRC cases in Indonesian patients showed an enormous increase in colon cancer in young patients, a particularly concerning trend. Additionally, young patients exhibited particular clinicopathological characteristics that contributed to disease severity.

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Is colorectal cancer a more aggressive disease in young patients? A population-based study from the Czech Republic

Cited by 18 publications

References 30 publications

Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors

Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors

WITHDRAWN: Prognostic Nomograms based on Homogeneous and Heterogeneous Associated Factors for Predicting the Overall Survival of Colorectal Cancer Patients with Distant Metastases

Analysing 11 years of incidence trends, clinicopathological characteristics, and forecasts of colorectal cancer in young and old patients: a retrospective cross-sectional study in an Indonesian national referral hospital

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