RT Journal Article
SR Electronic
T1 Patient and disease characteristics, treatment practices and oncologic outcomes among patients with colorectal cancer: a population-based analysis
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP E71
OP E78
DO 10.1503/cjs.024320
VO 66
IS 1
A1 Farooq, Ameer
A1 Keehn, Alysha R.
A1 Xu, Yuan
A1 Kong, Shiying
A1 Cheung, Winson Y.
A1 Quan, May Lynn
A1 MacLean, Anthony R.
YR 2023
UL http://canjsurg.ca/content/66/1/E71.abstract
AB Background: The incidence of colorectal cancer (CRC) is increasing among young adults. We sought to report on patient and disease characteristics, treatment practice patterns and outcomes in this population.Methods: We conducted a retrospective cohort study using administrative health data from the Alberta Cancer Registry (2004–2015), including demographic and tumour characteristics, and treatment received. Outcome measures included overall and cancer-specific deaths. We used Cox regression and Kaplan–Meier curves to assess for factors associated with survival.Results: We included 18 070 patients with CRC (n = 1583 [8.8%] < 50 yr, n = 16 487 [91.2 %] ≥ 50 yr). Younger patients were more likely to present with locally advanced disease (21.0% v. 18.0%, p < 0.0001), stage III (16.4 % v. 14.6%, p < 0.0001) or metastatic (16.7% v. 13.8%, p < 0.0001) involvement. Younger patients were more likely to receive surgery (87.2% v. 80.9%, p < 0.0001), chemotherapy (59.6% v. 34.1%, p < 0.0001) or radiation therapy (49.5% v. 37.2%, p < 0.001). At 5 years, overall and cancer-specific survival was better among younger patients than older patients (30.6% v. 51.5% overall deaths, 27.5% v. 38.4% cancer-specific deaths, p < 0.0001).Conclusion: Despite higher stage and higher grade disease, young patients with CRC had more favourable oncologic outcomes than stage-matched older patients, which may be related to younger patients receiving more aggressive treatment. Further investigation should focus on optimal treatment patterns for young patients with CRC.