512 Background: Colorectal cancer (CRC) incidence has declined overall with screening, though incidence in patients younger than 50 years has increased. Younger patients present with more aggressive and advanced stage CRC. Potential mechanisms are sporadic, genetics, and environmental (alcohol, smoking, metabolic syndrome). Metabolic syndrome (MetS) is an established risk factor for CRC. We examined the prevalence of MetS in younger patients ( < 50 yrs) compared with older patients ( ≥ 50 yrs) with CRC in a safety net hospital population. Methods: IRB-approved retrospective chart review of all patients diagnosed with CRC in the Harris County Hospital District cancer registry from Jan 2008 to Dec 2013. Data was collected for patient characteristics and metabolic syndrome to compare 2 patient groups: < 50 yr (younger) and ≥ 50 yr (older). MetS was defined using 2005 AHA/NHLBI criteria as ≥ 3 of the following components: abdominal obesity (waist circumference > 102 cm in men, > 88 cm in women), serum triglycerides (TG) ( > 150 mg/dL), serum HDL ( < 40 mg/dL in men and < 50 mg/dL in women), BP > 130/85 mmHg, fasting glucose/diabetes ( ≥ 100 mg/dL). Per WHO criteria, BMI > 30 was used as surrogate for waist circumference. Descriptive statistics were performed using t-test for continuous variables and Chi-square / Fisher’s exact test for categorical variables. Results: 625 cases of CRC diagnosed showed median age of 56.5 years and 54.7% female patients. The majority (77.76%) of cases occurred in the older group. Overall, 208/625 patients (33.28%) had MetS. Average BMI overall was 27.33. Prevalence of MetS was 38.27% vs 23% (older vs younger; p = 0.0001). In older compared with younger patients, average BMI 26.13 vs 25.05 (p = 0.02), obesity 25.92% vs 35.87% (p = 0.05), BP > 130/85 mmHg 56.3% vs 31.6% (p = 0.001), low HDL 41.7% vs 31.9% (p = 0.02), TG > 150 34.7 % vs 22.3 % (p = 0.02) and diabetes 36.2% vs 11.5% (p = 0.001). Conclusions: Overall prevalence of MetS in our patient cohort was similar to that of general population (which approximates 34%). Prevalence of MetS was higher in older patients with CRC than in younger patients, though this may reflect the natural history of MetS.
Transferred and Delayed Care of Patients with Colorectal Cancer in a Safety-Net Hospital System—Manifestations of a Distressed Healthcare System
