Primary Care Provider Knowledge and Practice in Risk Assessment for Early Age Onset Colorectal Cancer: Opportunities for Improvement

Parekh, Anjali; Hochheimer, Camille J.; Espinoza, Jeannine; Karlitz, Jordan J.; Lewis, Carmen L.; Wani, Sachin; Patel, Swati

doi:10.15430/jcp.2021.26.4.298

Cited by 6 publications

(3 citation statements)

References 17 publications

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“…Inadequate inquiries about family history of CRC or advanced adenomas and age of cancer onset likely contributes to untimely screening for increased-risk individuals. One study reported only 70% of primary care physicians routinely recommended CRC screening in young adults (40-to-49 years of age) with a first degree relative with colorectal cancer ( 26 ). Future studies assessing the barriers limiting inquiries (i.e.…”

Section: Discussionmentioning

confidence: 99%

Advancing early onset colorectal cancer research: research advocacy, health disparities, and scientific imperatives

Dwyer,

Rathod,

King

et al. 2024

Front. Oncol.

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Early onset colorectal cancer (EOCRC) emerged as the fourth foremost contributor to cancer-related mortality among both genders in the late 1990s. Presently, EOCRC (<50) ranks as the leading cause of cancer mortality in men and the second leading cause in women within the United States. Similar trends are now also evident globally, particularly in developed countries. Furthermore, there is strong evidence confirming that health disparities persist in the diagnosis and treatment of EOCRC, with signs indicating that these gaps may worsen in specific cases. These alarming trends highlight the critical need for research to inform evidence-based interventions to reduce the burden of EOCRC globally. Fight Colorectal Cancer (Fight CRC) is the leading patient advocacy group in the United States providing information on colon and rectal cancer research, prevention, treatment, and policy. It is the opinion of Fight CRC that an international, coordinated effort with the medical, research, scientific, advocacy, industry and funding community is needed to advance impactful research. Fight CRC, in partnership with José Perea, MD, PhD, of the Institute of Biomedical Research of Salamanca (IBSAL) in Spain, and partners, are working together to address this global phenomenon and are presenting a multi-faceted research approach to move the field forward.

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Section: Discussionmentioning

confidence: 99%

Advancing early onset colorectal cancer research: research advocacy, health disparities, and scientific imperatives

Dwyer,

Rathod,

King

et al. 2024

Front. Oncol.

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“…Globally, colorectal cancer (CRC) among individuals under the age of 50 is commonly referred to as early-onset colorectal cancer (EOCRC), 1 and its incidence is steadily increasing, 2,3 with China being no exception. 4 EOCRC tends to be more subtle, typically being diagnosed in later stages and having a poorer prognosis, [5][6][7] leading to greater disability and higher healthcare expenses.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors of colorectal neoplasia in individuals aged 40–49 years: Findings from screening program in China

Zhang,

Zhang

et al. 2024

J of Gastro and Hepatol

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Background and AimThe incidence of colorectal cancer (CRC) in individuals under 50 is increasing worldwide. We conducted an analysis of colonoscopy findings in high‐risk individuals under 50 in the CRC screening program in Tianjin, China, to determine the detection rate and risk factors of advanced adenomas (AA), advanced colorectal neoplasia (ACN), colorectal neoplasia (CN).MethodsOur study investigated individuals aged 40–49 who underwent CRC screening and completed colonoscopy, 2012–2020, while the 50–54 age group served as a control. We compared the detection rates of AA, ACN, and CN among three age groups using univariate and multivariable logistic regression analyses, and investigated the risk factors associated with AA, ACN, and CN among individuals aged 40–49.ResultsWe found a gradual increase in the detection rate of AA, ACN, and CN among individuals aged 40–54. The detection rates for AA (OR 0.58; 95% CI 0.41–0.81), ACN (OR 0.58; 95% CI 0.43–0.77), and CN (OR 0.64; 95% CI 0.56–0.74) were lower in individuals aged 40–44 compared to 45–49. The detection rates of AA (OR 1.08; 95% CI 0.87–1.34) and ACN (OR 1.12; 95% CI 0.93–1.35) in individuals aged 45–49 were comparable with 50–54. Besides, lifestyle factors, BMI, and FIT are not associated with the detection rates of AA, ACN, and CN among individuals aged 40–49.ConclusionsOur study reveals screening data in individuals under 50, indicating comparable detection rates of AA and ACN in individuals aged 45–49 and 50–54. These findings provide valuable data support for optimizing the optimal age to initiate screening.

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“…Possible explanations include patient-related factors, such as lack of knowledge about symptoms which may contribute to a longer time to diagnosis [12,13]. Provider-related factors have also been shown to play a role in delaying diagnosis where, despite younger patients presenting with symptoms that should prompt investigation of CRC, there may be a low suspicion among health care providers [14,15]. Given these issues, our objectives were to (1) characterize the pattern of symptoms at presentation in EoCRC compared to LoCRC, (2) identify differences in the number of symptoms at presentation and whether this associates with survival, and (3) assess if EoCRC patients experience a longer time to diagnosis compared to LoCRC and how this impacts survival.…”

Section: Introductionmentioning

confidence: 99%

Symptom Burden and Time from Symptom Onset to Cancer Diagnosis in Patients with Early-Onset Colorectal Cancer: A Multicenter Retrospective Analysis

Baronas,

Arif,

Bhang

et al. 2024

Current Oncology

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Background: The incidence of colorectal cancer (CRC) is decreasing in individuals >50 years due to organised screening but has increased for younger individuals. We characterized symptoms and their timing before diagnosis in young individuals. Methods: We identified all patients diagnosed with CRC between 1990–2017 in British Columbia, Canada. Individuals <50 years (n = 2544, EoCRC) and a matched cohort >50 (n = 2570, LoCRC) underwent chart review to identify CRC related symptoms at diagnosis and determine time from symptom onset to diagnosis. Results: Across all stages of CRC, EoCRC presented with significantly more symptoms than LoCRC (Stage 1 mean ± SD: 1.3 ± 0.9 vs. 0.7 ± 0.9, p = 0.0008; Stage 4: 3.3 ± 1.5 vs. 2.3 ± 1.7, p < 0.0001). Greater symptom burden at diagnosis was associated with worse survival in both EoCRC (p < 0.0001) and LoCRC (p < 0.0001). When controlling for cancer stage, both age (HR 0.87, 95% CI 0.8–1.0, p = 0.008) and increasing symptom number were independently associated with worse survival in multivariate models. Conclusions: Patients with EoCRC present with a greater number of symptoms of longer duration than LoCRC; however, time from patient reported symptom onset was not associated with worse outcomes.

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Primary Care Provider Knowledge and Practice in Risk Assessment for Early Age Onset Colorectal Cancer: Opportunities for Improvement

Cited by 6 publications

References 17 publications

Advancing early onset colorectal cancer research: research advocacy, health disparities, and scientific imperatives

Advancing early onset colorectal cancer research: research advocacy, health disparities, and scientific imperatives

Prevalence and risk factors of colorectal neoplasia in individuals aged 40–49 years: Findings from screening program in China

Symptom Burden and Time from Symptom Onset to Cancer Diagnosis in Patients with Early-Onset Colorectal Cancer: A Multicenter Retrospective Analysis

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