Rectal cancer in the young: analysis of contributing factors and surgical outcomes

Mogor, Odinaka P.; Ewongwo, Agnes; Ojameruaye, Ogaga; Pandit, Viraj; Omesiete, Pamela; Martínez, Carolina; Hsu, Paul; Scott, Aaron J.; Elquza, Emad; Nfonsam, Valentine

doi:10.21037/jgo.2019.05.06

Cited by 1 publication

(10 citation statements)

References 25 publications

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Section: Resultsmentioning

confidence: 99%

“…Of the 12 859 unique articles retrieved, 699 full texts were reviewed, and 81 studies were included (Figure 1 and Table). There were 76 cross-sectional studies, 4 case-control studies, and 1 cohort study . Studies were performed in Africa (5 studies), Asia or the Middle East (26 studies), Europe (19 studies), North America (23 studies), South America (5 studies), and Oceania (2 studies) .…”

Section: Resultsmentioning

confidence: 99%

“…There were 76 cross-sectional studies, 4 case-control studies, and 1 cohort study . Studies were performed in Africa (5 studies), Asia or the Middle East (26 studies), Europe (19 studies), North America (23 studies), South America (5 studies), and Oceania (2 studies) . There were 67 studies deemed to have low risk of bias, 10 studies with moderate risk of bias, and 4 studies with high risk of bias, based on JBI checklists.…”

Section: Resultsmentioning

confidence: 99%

“…Studies were performed in Africa (5 studies), Asia or the Middle East (26 studies), Europe (19 studies), North America (23 studies), South America (5 studies), and Oceania (2 studies) . There were 67 studies deemed to have low risk of bias, 10 studies with moderate risk of bias, and 4 studies with high risk of bias, based on JBI checklists. Notable sources of bias included using patient-reported or inadequately defined measures of signs or symptoms and time to diagnosis (eTable 2 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

“…There were 78 studies that reported on 17 signs and symptoms at presentation, based on claims or medical records (66 studies), patient report (6 studies), or other (7 studies) . (Figure 2; eFigure 1 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

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Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer

Demb,

Kolb,

Dounel

et al. 2024

JAMA Netw Open

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ImportanceEarly-onset colorectal cancer (EOCRC), defined as a diagnosis at younger than age 50 years, is increasing, and so-called red flag signs and symptoms among these individuals are often missed, leading to diagnostic delays. Improved recognition of presenting signs and symptoms associated with EOCRC could facilitate more timely diagnosis and impact clinical outcomes.ObjectiveTo report the frequency of presenting red flag signs and symptoms among individuals with EOCRC, to examine their association with EOCRC risk, and to measure variation in time to diagnosis from sign or symptom presentation.Data SourcesPubMed/MEDLINE, Embase, CINAHL, and Web of Science were searched from database inception through May 2023.Study SelectionStudies that reported on sign and symptom presentation or time from sign and symptom presentation to diagnosis for patients younger than age 50 years diagnosed with nonhereditary CRC were included.Data Extraction and SynthesisData extraction and quality assessment were performed independently in duplicate for all included studies using Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. Joanna Briggs Institute Critical Appraisal tools were used to measure risk of bias. Data on frequency of signs and symptoms were pooled using a random-effects model.Main Outcomes and MeasuresOutcomes of interest were pooled proportions of signs and symptoms in patients with EOCRC, estimates for association of signs and symptoms with EOCRC risk, and time from sign or symptom presentation to EOCRC diagnosis.ResultsOf the 12 859 unique articles initially retrieved, 81 studies with 24 908 126 patients younger than 50 years were included. The most common presenting signs and symptoms, reported by 78 included studies, were hematochezia (pooled prevalence, 45% [95% CI, 40%-50%]), abdominal pain (pooled prevalence, 40% [95% CI, 35%-45%]), and altered bowel habits (pooled prevalence, 27% [95% CI, 22%-33%]). Hematochezia (estimate range, 5.2-54.0), abdominal pain (estimate range, 1.3-6.0), and anemia (estimate range, 2.1-10.8) were associated with higher EOCRC likelihood. Time from signs and symptoms presentation to EOCRC diagnosis was a mean (range) of 6.4 (1.8-13.7) months (23 studies) and a median (range) of 4 (2.0-8.7) months (16 studies).Conclusions and RelevanceIn this systematic review and meta-analysis of patients with EOCRC, nearly half of individuals presented with hematochezia and abdominal pain and one-quarter with altered bowel habits. Hematochezia was associated with at least 5-fold increased EOCRC risk. Delays in diagnosis of 4 to 6 months were common. These findings highlight the need to identify concerning EOCRC signs and symptoms and complete timely diagnostic workup, particularly for individuals without an alternative diagnosis or sign or symptom resolution.

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Section: Resultsmentioning

confidence: 99%