Younger age at onset of colorectal cancer is associated with increased patient’s delay

Abstract

This study aimed to investigate if younger age at diagnosis of colorectal cancer was associated with a diagnostic delay. The secondary objective was to evaluate if symptomatology varied with age. Method: The study population consisted of the cohorts from two prospective multicentre studies conducted in Sweden and Denmark, the QoLiRECT and QoLiCOL studies. These studies investigated the quality of life in patients with colorectal cancer. Participants responded to the validated questionnaires used to extract information on patient's and doctor's delay as well as first presenting symptoms. Clinical variables were retrieved from the Swedish Colorectal Cancer Registry and the Danish Colorectal Cancer Group Database. Results: 2574 patients were included, 1085 from QoLiRECT and 1489 from QoLiCOL. The probability of an increased patient's delay was higher when age decreased by 10 years (the SD in both QoLiRECT and QoLiCOL), adjusted OR 1.19 (95%CI: 1.10; 1.30), p < 0.001. A similar effect was found for doctor's delay, but the age effect was smaller in this case, adjusted OR 1.05 (95%CI: 0.97; 1.15), p Z 0.177. When the age effect was analysed nonlinearly, an increased probability of a delay was seen for patients from around 60 years and below. Younger patients were equally or more likely to report the symptoms of blood in stool, diarrhoea, constipation, mucus in faeces, faecal urgency, faecal emptying difficulties and pain compared to older patients. Conclusion: Younger patients were more likely to have an increased patient's delay, probably contributing to a delayed diagnosis of colorectal cancer. Symptomatology at diagnosis was

Transition, obligations and isolation: A qualitative exploration of psychosocial challenges in working-age colorectal cancer patients

“…The result is consistent with some quantitative studies indicating younger CRC patients were associated with increased likelihood of psychological distress [6,24]. A possible explanation for this is that younger patients may be more likely to disregard symptoms of CRC as they perceive themselves to be healthy, leading to maladaptation to the sick role and delay in diagnosis [25]. It has been reported that the probability of a long patient's delay and late stage was increased in CRC patients 60 years or younger, who still work may be less prone to seek medical advice due to lack of time.…”

Identification of functional gene modules by integrating multi-omics data and known molecular interactions

“…CRC is the third most common malignant cancer with the second highest mortality rate ( Ayerden et al, 2021 ; Rydbeck et al, 2021 ; Peng et al, 2022 ). By applying CLAM to multi-omics data of CRC (see ‘Data collection and preprocessing’) with KNN ranging from 5 to 15, we obtained 88, 71, 59, 49, 42, 37, 35, 28, 27, 25 and 23 gene modules.…”

Adverse Tumour and Host Biology May Explain the Poorer Outcomes Seen in Emergency Presentations of Colon Cancer

“…38 In younger patients, there may be delays by either patient or health care provider to report/investigate lower GI symptoms due to the higher likelihood of these resulting from less significant benign pathology. 39 Alternatively, recent studies have shown that earlyonset colorectal cancer is increasing in incidence and associated with adverse outcomes suggesting more aggressive disease characteristics that may predispose to emergency presentation. [40][41][42] Within the present study, both OS and CSS were analyzed.…”