Racial disparities in clinico-pathological features and survival rates of early-onset colorectal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15089-e15089
Author(s):  
Ana Acuna Villaorduna ◽  
Meghan Kaumaya ◽  
Sanjay Goel
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Early Onset ◽  
Survival Rates ◽  
Screening Colonoscopy ◽  
Pathological Features ◽  
Risk Of Death ◽  
Common Location ◽  
Increased Risk ◽  
Early Onset Colorectal Cancer

e15089 Background: Early-onset colorectal cancer (EO-CRC) incidence is increasing disproportionately among minorities compared to Non-Hispanic Whites (NHW). EO-CRC have aggressive features such as higher grade and advanced stages. The appropriate age to start screening colonoscopy (SC) in NHW and minorities remains controversial; varying between 45 and 50 years old. We aim to compare EO-CRC clinico-pathological characteristics and survival rates by race groups. Methods: Patients with colorectal adenocarcinoma (CRC) with available race and stage as per AJCC 6th edition were identified using the SEER registry (1973-2010). EO-CRC was defined as CRC before age 50 years. Clinico-pathological features, overall survival (OS) by Kaplan Meier curves and mortality predictors by multivariate analysis were evaluated by race groups. Results: 180 605 patients with CRC were identified; 10.2% had EO-CRC. Mean age of diagnosis was 42.7 years and EO-CRC frequency was higher in minorities (Hispanics (H):16.7%, Non-Hispanic Black (NHB):12.7% and Asian (A): 12.8%) compared to NHW (8.7%). EO-CRC in NHB was predominantly seen in females. The rectum was the most common location for all races. Two-thirds of tumors were located between the sigmoid and anal regions in all races except NHB that had higher frequencies of right-sided tumors. Compared to other races, NHB had worse OS at all stages and tumor locations. NHB was associated with 72% increased risk of death by multivariate analysis. Conclusions: Our data suggest that EO-CRC frequency, pathological features and OS differ by race group; hence SC guidelines should be tailored accordingly. SC would be considered early; especially in minorities. Complete colonoscopy should be considered for NHB given higher rates of right-sided tumors and worse OS; while sigmoidoscopy may be adequate for others up to age 50, given higher rates of tumors located in the sigmoid to anal region. [Table: see text]

Racial ethnic disparities in clinical/pathological features, treatment, and survival among patients with early-onset colorectal cancer.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 21-21
Author(s):  
Michael Lyudmer ◽  
Riya Jayesh Patel ◽  
Adel Chergui ◽  
Seda Serra Tolu ◽  
Devika Rao ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Data ◽  
Early Onset ◽  
Ethnic Disparities ◽  
Pathological Features ◽  
Biologic Treatment ◽  
Kras Mutations ◽  
Exact Test ◽  
Racial Ethnic ◽  
Early Onset Colorectal Cancer

21 Background: Globally, the incidence of early-onset colorectal cancer has risen. Racial disparities in colorectal cancer (CRC) are well-described, however data in EO by race/ethnicity is lacking. We aim to compare the presenting features, treatment, and survival features of patients with metastatic early-onset CRC (EO). Methods: Patients with metastatic CRC diagnosed between 2010-2019 at two NYC hospitals were identified by tumor registry (n = 646). Clinical/pathological features, treatment and survival data was collected by chart review and compared between Non-Hispanic Whites (NHW), Non-Hispanic Blacks (NHB) and Hispanics (H) using Chi-square or Fisher’s exact test. Kaplan Meier curves were plotted to compare overall survival (OS) among groups. Stata v15 was used for statistical analysis. Results: Of 646 CRC patients, 126 (21.5%) were NHW, NHB or H diagnosed with EO with a frequency ranging from 16.6% in NHW to 26.1% in H. Non statistically significant lower frequencies of male gender, low/moderate grade, left-sided tumors,and higher frequency of KRAS mutations were seen in NHB (Table). Metastectomy was performed in 20 patients (13.9%) and did not differ between groups. There was no difference in the use of chemotherapy or biologics in general (Table), but NHW were more likely to get cetuximab than NHB (OR:4.5, p = 0.02) and H (OR:4.7, p = 0.02).There were no differences in median OS (1.8 vs. 2.2 vs. 2 years, p = 0.9)or 1-year OS (72% vs 72.3% vs 70.8%) in NHW, NHB and H, respectively. A lower 5-year OS was seen in NBH (14.5%) and Hispanics (24.4%) compared to NHW (44%). Conclusions: EO-CRC is more frequently seen in minority racial/ethnic groups. Despite no differences in the use of chemotherapy or biologic treatment in general, NHB have a lower 5-year survival rate compared to NHW and H. [Table: see text]

scholarly journals Early-onset colorectal cancer: more than one side to the story

2020 ◽  
Vol 9 (3) ◽  
pp. CRC28
Author(s):  
Nina N Sanford ◽  
Pooja Dharwadkar ◽  
Caitlin C Murphy
Keyword(s):  
Colorectal Cancer ◽  
Early Onset ◽  
Age Groups ◽  
Younger Adults ◽  
Risk Of Death ◽  
Colon Cancers ◽  
All Cause Mortality ◽  
Colon And Rectum ◽  
The Impact ◽  
Early Onset Colorectal Cancer

Aim: To determine the impact of tumor sidedness on all-cause mortality for early- (age 18–49 years) and older-onset (age ≥50 years) colorectal cancer (CRC). Materials & methods: We conducted a retrospective study of 650,382 patients diagnosed with CRC between 2000 and 2016. We examined the associations of age, tumor sidedness (right colon, left colon and rectum) and all-cause mortality. Results: For early-onset CRC (n = 66,186), mortality was highest in the youngest age group (18–29 years), driven by left-sided colon cancers (vs 50–59 years, hazard ratio: 1.18; 95% CI: 1.03–1.34). 5-year risk of death among 18–29-year-olds with left-sided colon cancer (0.42, 95% CI: 0.38, 0.46) was higher than all other age groups. Conclusion: Left-sided colon cancers are enriched in younger adults and may be disproportionately fatal.

Metabolic syndrome, metabolic comorbid conditions and risk of early-onset colorectal cancer

Gut ◽  
2020 ◽  
pp. gutjnl-2020-321661 ◽  
Author(s):  
Hanyu Chen ◽  
Xiaobin Zheng ◽  
Xiaoyu Zong ◽  
Zitong Li ◽  
Na Li ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metabolic Syndrome ◽  
Colon Cancer ◽  
Early Onset ◽  
Distal Colon ◽  
Comorbid Condition ◽  
Comorbid Conditions ◽  
Metabolic Dysregulation ◽  
Increased Risk ◽  
Early Onset Colorectal Cancer

ObjectiveFactors that lead to metabolic dysregulation are associated with increased risk of early-onset colorectal cancer (CRC diagnosed under age 50). However, the association between metabolic syndrome (MetS) and early-onset CRC remains unexamined.DesignWe conducted a nested case–control study among participants aged 18–64 in the IBM MarketScan Commercial Database (2006–2015). Incident CRC was identified using pathologist-coded International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, and controls were frequency matched. MetS was defined as presence of ≥3 conditions among obesity, hypertension, hyperlipidaemia and hyperglycaemia/type 2 diabetes, based on ICD-9-CM and use of medications. Multivariable logistic regressions were used to estimate ORs and 95% CIs.ResultsMetS was associated with increased risk of early-onset CRC (n=4673; multivariable adjusted OR 1.25; 95% CI 1.09 to 1.43), similar to CRC diagnosed at age 50–64 (n=14 928; OR 1.21; 95% CI 1.15 to 1.27). Compared with individuals without a metabolic comorbid condition, those with 1, 2 or ≥3 conditions had a 9% (1.09; 95% CI 1.00 to 1.17), 12% (1.12; 95% CI 1.01 to 1.24) and 31% (1.31; 95% CI 1.13 to 1.51) higher risk of early-onset CRC (ptrend <0.001). No associations were observed for one or two metabolic comorbid conditions and CRC diagnosed at age 50–64. These positive associations were driven by proximal (OR per condition 1.14; 95% CI 1.06 to 1.23) and distal colon cancer (OR 1.09; 95% CI 1.00 to 1.18), but not rectal cancer (OR 1.03; 95% CI 0.97 to 1.09).ConclusionsMetabolic dysregulation was associated with increased risk of early-onset CRC, driven by proximal and distal colon cancer, thus at least in part contribute to the rising incidence of early-onset CRC.

scholarly journals The sulfur microbial diet is associated with increased risk of early-onset colorectal cancer precursors

2021 ◽  
Author(s):  
Long H. Nguyen ◽  
Yin Cao ◽  
Jinhee Hur ◽  
Raaj S. Mehta ◽  
Daniel R. Sikavi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Early Onset ◽  
Increased Risk ◽  
Cancer Precursors ◽  
Early Onset Colorectal Cancer

Metabolic syndrome, metabolic comorbid conditions, and risk of early-onset colorectal cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1571-1571
Author(s):  
Hanyu Chen ◽  
Zitong Li ◽  
Xiaobin Zheng ◽  
Jinhee Hur ◽  
Xiaoyu Zong ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metabolic Syndrome ◽  
Early Onset ◽  
Distal Colon ◽  
Comorbid Conditions ◽  
Diagnosis Codes ◽  
Increased Risk ◽  
Rising Incidence ◽  
Early Onset Colorectal Cancer

1571 Background: The etiology and contributors to the rising incidence of early-onset colorectal cancer (CRC diagnosed under age 50), driven largely by distal and rectal cancer, remain largely unknown. Metabolic syndrome is associated with higher risk of CRC diagnosed at older ages; however, its association with early-onset CRC remains unclear. Methods: We conducted a nested case-control study among participants aged 18-50 years with ≥2 years of enrollment and prescription drug coverage in the IBM MarketScan Commercial Databases (2006-2015). Incident CRC cases were identified using ICD-9-CM diagnosis codes. Controls without any cancer were identified using frequency matching on age, sex, geographical region, and duration of insurance enrollment. Metabolic syndrome was defined using either ICD-9-CM diagnosis codes or the presence of at least 3 of the following: obesity, hypertension, hyperlipidemia, and hyperglycemia/type 2 diabetes. In addition to ICD-9-CM codes, hypertension, hyperlipidemia, and hyperglycemia/type 2 diabetes were also defined based on regular use of medications. Multivariable logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: A total of 4,673 early-onset CRC and 40,832 controls were included. Metabolic syndrome was associated with increased risk of early-onset CRC (OR: 1.33, 95% CI 1.16-1.52), after adjusting for a range of potential confounders. The number of metabolic comorbid conditions was positively associated with risk of early-onset CRC in a dose-response fashion. Compared to individuals without any conditions, individuals with 1, 2, ≥3 metabolic conditions had a 13% (OR: 1.13, CI 1.04-1.22), 18% (OR: 1.18, CI 1.07-1.31), and 40% (OR: 1.40, CI 1.22-1.61) higher risk of early-onset CRC (Ptrend<0.001), respectively. These associations were driven by proximal (OR for ≥2 vs 0 metabolic comorbid conditions: 1.40, CI 1.15-1.69) and distal colon cancer, OR ≥2 vs 0: 1.25, CI 1.03-1.53), but not rectal cancer (OR≥2 vs 0: 1.07, CI 0.92-1.24). Conclusions: Metabolic syndrome and metabolic comorbid conditions were associated with increased risk of early-onset CRC, largely driven by proximal and distal colon cancer. Metabolic dysregulations may contribute to the rising incidence of early-onset CRC.

Characteristics and survival among early onset and standard onset colorectal cancer by race.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 522-522 ◽  
Author(s):  
Ana Acuna Villaorduna ◽  
Sanjay Goel
Keyword(s):  
Colorectal Cancer ◽  
Clinical Features ◽  
Early Onset ◽  
Minority Groups ◽  
Age Groups ◽  
Screening Colonoscopy ◽  
Racial Groups ◽  
Early Screening ◽  
Race Ethnicity ◽  
Early Onset Colorectal Cancer

522 Background: The incidence of early-onset colorectal cancer (EO) is increasing. Guidelines recommend to start screening colonoscopy at 45 yo in Non-Hispanic Black (NHB). We compare the clinical features and outcomes between EO and standard-onset (SO) colorectal cancer (CRC) among racial groups. Methods: Patients with CRC adenocarcinoma; available race/ethnicity and stage were identified using the SEER registry. Clinical features and 5 year-overall survival (OS) is described by racial and age groups. Results: 190 670 patients were identified. EO rates were higher for minorities than NHW. Median age at diagnosis in EO was 44 and was similar among racial groups; while it was 71 in SO, being lower among minorities compared to NHW (67 vs. 72 years, p < 0.01). Left-sided tumors accounted for 77.4% of tumors in EO while it was 60.8% in SO for minorities versus NHW. The most common CRC location for EO was the rectum and sigmoid colon for SO. EO was most commonly diagnosed as stage III. Surgery and radiation rates were higher for EO for all stages. OS was higher in all stages of EO compared to SO. Conclusions: EO frequency is higher in all minority groups and most commonly located in the rectum. Despite higher stage and grade, OS is higher for EO which might be due to higher treatment rates. Early screening should be extended to all minority groups. [Table: see text]

scholarly journals Survival Rate of Colorectal Cancer and Its Effective Factors in Iran

2021 ◽  
Author(s):  
Mohammad Abbasi ◽  
Saeedeh Asgari ◽  
Azar Pirdehghan ◽  
Abdol Azim Sedighi Pashaki ◽  
Farzaneh Esna-Ashari
Keyword(s):  
Colorectal Cancer ◽  
Survival Rate ◽  
Cox Regression ◽  
Survival Rates ◽  
Early Screening ◽  
Cox Regression Analysis ◽  
Effective Factors ◽  
Risk Of Death ◽  
Phone Calls ◽  
Increased Risk

Colorectal cancer is one of the most common cancers in Iran. Regarding the prevalence of this cancer and its mortality and morbidity, in this study, 5 Year Survival Rate and its Effective Factors of patients with colorectal cancer were investigated. This study was conducted using the retrospective cohort method. All patients diagnosed with colorectal cancer in Hamadan Imam Khomeini Clinic of Hematology and Oncology and Mahdieh Oncology Center between 2006 and 2011 were studied. Data were extracted from the patients’ medical records, and to obtain extra information about them, telephone calls were made. The data were analyzed by SPPS version 16, and the assessment of survival rates was conducted using Kaplan-Meier methods and Cox regression method. A total number of 108 patients with colorectal cancer were studied. The status of 74 patients was determined at the end of the study by making follow-up phone calls. The one, two, three, four, and five survival rates were 77, 66, 50, 45, and 42%, respectively. The median overall survival was 46.8 months (1.3-135.6 months). Cox regression analysis showed that Metastatic tumor (P=0.001), lymphatic involvement (P=0.043), and is associated with underlying disease (P=0.025) was accompanied by increased risk. Multivariate cox regression test showed that metastasis was associated with an increase in the risk of death significantly (HR=2.83, P=0.013). According to the findings of the study, early screening is recommended for people with greater risk to increase the survival rate.

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