Stage-specific conditional survival among young versus older adults with colorectal cancer in the United States, 2004-2010.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 257-257 ◽  
Author(s):  
Nina Niu Sanford ◽  
Chul Ahn ◽  
Michael Ryan Folkert ◽  
Todd Anthony Aguilera ◽  
David J. Sher
Keyword(s):  
Colorectal Cancer ◽  
Older Adults ◽  
Colon Cancer ◽  
Stage Iv ◽  
The United States ◽  
Adult Patients ◽  
Conditional Survival ◽  
Younger Adults ◽  
Entire Study ◽  
Over Time

257 Background: Conditional survival (CS) is a relevant prognostic measure for cancer survivors and physicians and may be particularly important for young adult patients with CRC (colorectal cancer), whose incidence is rising. We sought to compare CS among young versus older adults with CRC. Methods: Patients diagnosed with colon or rectal adenocarcinoma between 2004-2010 were identified from the Surveillance, Epidemiology and End Results (SEER) registry. Overall survival (OS) and cancer-specific survival (CSS) were estimated, along with smoothed yearly hazards of death due to CRC, other causes and any cause, stratified by age at diagnosis ( < 50 vs. >50 years). Stage-specific conditional 5-year OS and 5-year CSS given that patients had already survived 1, 2, 3, 4 or 5 years after diagnosis was calculated, also stratified by age. Results: Among 161,859 patients with median follow-up of 54 months, 35,411 (21.9%) were aged < 50 years. Both OS and CSS were superior among younger adult as compared to older adult patients (p < 0.001). For older adults with rectal cancer, hazards of death due to non-cancer causes exceeded that of rectal and colon cancer approximately 6 and 4.5 years after diagnosis, respectively. Among younger adults, hazard of death from cancer remained greater than death from other causes throughout the entire study interval. Patients experienced improved conditional survival over time with greater improvement seen for more advanced stages. However, young adults had less CS improvement over time than older adults. For example, the 5-year overall and CSS for Stage IV colon cancer improved from 7.4% to 52.4%% (OS) and 15.1% to 78.5% (CSS) 0 to 5 years after diagnosis for older adults. In contrast, for younger adults, the 5-year overall and CSS for Stage IV colon cancer improved from 15.6% to 57% (OS) and 19.3% to 68.4% (CSS). Conclusions: Prognosis for CRC improves over time for all patients, although the increase in survival appears to be less for younger than older adults. Up to 10 years after diagnosis, the primary cause of death in younger adults with CRC remains their incident cancer.

scholarly journals Practical Application of a Calculator for Conditional Survival in Colon Cancer

2009 ◽  
Vol 27 (35) ◽  
pp. 5938-5943 ◽  
Author(s):  
George J. Chang ◽  
Chung-Yuan Hu ◽  
Cathy Eng ◽  
John M. Skibber ◽  
Miguel A. Rodriguez-Bigas
Keyword(s):  
Colon Cancer ◽  
Colon Adenocarcinoma ◽  
Stage Iv ◽  
Conditional Survival ◽  
Prognostic Information ◽  
Sixth Edition ◽  
Time Determination ◽  
Multivariate Survival Model ◽  
Over Time

Purpose Conditional survival (CS) estimates provide important prognostic information for clinicians and patients who have survived a period after diagnosis. In this study we performed a contemporary evaluation of conditional survival among colon cancer patients and created a browser-based tool for real-time determination of conditional survival expectancies. Patients and Methods Patients with colon adenocarcinoma diagnosed between 1988 and 2000 were identified from the Surveillance Epidemiology End Results (SEER) registry. Conditional survival estimates were calculated by using the multiplicative law of probability after adjustment for age; sex; ethnicity; grade; and American Joint Commission on Cancer, sixth edition stage. A browser-based calculator was constructed. Results A total of 83,419 patients were analyzed. As the time alive after initial treatment increased from 0 to 5 years, significant improvements in CS were observed for patients in all stages except stage I, which was associated with good CS even at diagnosis and which reflected the high likelihood of cure. Notably, adjusted 5-year CS rates improved from 42% to 80% for stage IIIC cancers and from 5% to 48% for stage IV cancers during the first 5 years. Differences in cancer-related CS at diagnosis were identified on the basis of age, ethnicity, and grade, but these differences decreased over time. A browser-based CS calculator was implemented by using the multivariate survival model (concordance index, 0.81). Conclusion For patients with colon cancer who survive over time, 5-year, cancer-specific CS improved dramatically, and the greatest improvements were among patients with poorer initial prognoses. These prognostic data are critical to inform patients for non–treatment-related life decisions and to inform treating physicians for planning of follow-up and surveillance strategies.

Recent trends in age at diagnosis of colon cancer in the United States, 2004-2015, a National Cancer Database study.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 490-490
Author(s):  
Boone Wilder Goodgame ◽  
Jack Virostko ◽  
Anna Capasso ◽  
Thomas Yankeelov
Keyword(s):  
Colorectal Cancer ◽  
Rural Areas ◽  
Urban Areas ◽  
Advanced Disease ◽  
The United States ◽  
National Cancer Database ◽  
Younger Adults ◽  
Number Of Patients ◽  
The Us ◽  
Over Time

490 Background: The incidence of colorectal cancer (CRC) in adults younger than age 50 has been increasing in the US since 1970. The US Preventive Services Task Force recommends screening for CRC beginning at age 50, while the American Cancer Society recently revised its guidelines to advise screening at age 45. We analyzed the National Cancer Database (NCDB) from 2004 through 2015 to determine whether the proportion of patients diagnosed younger than 50 has changed during this time. Methods: This was a retrospective study of NCDB data, which includes more than 70 percent of newly diagnosed cancer cases in the US. We examined the proportion of patients diagnosed prior to age 50 as our primary endpoint. We used the Cochran–Armitage test for trend to assess changes in the proportion of cases diagnosed at age < 50 years old as a function of year of diagnosis. Results: We identified 152,749 patients diagnosed under age 50 and 1,033,014 patients diagnosed at age 50 or greater. Over the study period, the proportion of the total number of patients diagnosed with colorectal cancer under age 50 increased (14.3% in 2015 vs. 11.5% in 2004, p < 0.0001). Younger adults with CRC presented with more advanced disease, with 49.9% stage III or IV disease, as compared to 40.0% in those diagnosed over age 50. Both men and women had a rising proportion of cases diagnosed younger than 50 (p < 0.0001) over time. In men, only non-Hispanic whites had an increase in diagnosis at ages less than 50 (p < 0.0001), while in women, all racial and ethnic subgroups had an increase in younger diagnoses over time (p < 0.01). All income quartiles (p < 0.001) demonstrated a proportional increase in younger adults over time, with the highest income quartile having the highest proportion of younger cases. The proportion of younger-onset CRC rose in urban areas (p < 0.001), but did not rise in rural areas. Conclusions: The proportion of persons diagnosed with CRC under age 50 in the US has continued to increase over the past decade. Younger adults presented with more advanced disease, suggesting that screening could improve outcomes.

scholarly journals Working with Individuals Who Provide Nursing Care to Educate Older Adults about Foodborne Illness Prevention: The Food Safety Because You Care! Intervention

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Kelly C. Wohlgenant ◽  
Sandria L. Godwin ◽  
Sheryl C. Cates ◽  
Richard Stone
Keyword(s):  
Older Adults ◽  
Food Safety ◽  
Older Adult ◽  
Nursing Care ◽  
The United States ◽  
Adult Patients ◽  
Younger Adults ◽  
Safety Practices ◽  
Illness Prevention ◽  
Foodborne Infections

Older adults are more susceptible to foodborne infections than younger adults and many older adults do not follow recommended food safety practices. This study implemented the Food Safety Because You Care! program with 88 individuals in the United States who provide nursing care to older adult patients and subsequently surveyed them. The majority of respondents had favorable opinions of the program. Following program exposure, many of the respondents advised their older adult patients about food safety. The findings from this study suggest that the program is a useful tool that can assist those who provide nursing care as they interact with their older patients and lead them to positively influence older adults’ food safety practices. However, more research is needed to examine changes in providers’ behaviors as a result of program exposure and the accompanying effect on older adults’ food safety practices.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

Age Differences in the Social Associative Learning of Trust Information

2022 ◽  
Author(s):  
Kendra Leigh Seaman ◽  
Alexander P. Christensen ◽  
Katherine Senn ◽  
Jessica Cooper ◽  
Brittany Shane Cassidy
Keyword(s):  
Older Adults ◽  
Age Differences ◽  
Social Cues ◽  
Trust Game ◽  
Time Model ◽  
Younger Adults ◽  
Cortical Areas ◽  
Age Related ◽  
The Social ◽  
Over Time

Trust is a key component of social interaction. Older adults, however, often exhibit excessive trust relative to younger adults. One explanation is that older adults may learn to trust differently than younger adults. Here, we examine how younger (N=33) and older adults (N=30) learn to trust over time. Participants completed a classic iterative trust game with three partners. Younger and older adults shared similar amounts but differed in how they shared money. Compared to younger adults, older adults invested more with untrustworthy partners and less with trustworthy partners. As a group, older adults displayed less learning than younger adults. However, computational modeling shows that this is because older adults are more likely to forget what they have learned over time. Model-based fMRI analyses revealed several age-related differences in neural processing. Younger adults showed prediction error signals in social processing areas while older adults showed over-recruitment of several cortical areas. Collectively, these findings suggest that older adults attend to and learn from social cues differently from younger adults.

Abstract 88: Increasing False Positive Diagnoses May Lead to Overestimation of Stroke Incidence, Particularly in the Young

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Abhinav J Appukutty ◽  
Lesli E Skolarus ◽  
Mellanie V Springer ◽  
William J Meurer ◽  
James F Burke
Keyword(s):  
Older Adults ◽  
False Positive ◽  
Age Groups ◽  
Vascular Risk Factor ◽  
The United States ◽  
Cross Sectional ◽  
Stroke Incidence ◽  
Ed Visits ◽  
Over Time

Introduction: Stroke incidence is reportedly increasing in younger adults. While increasing vascular risk factor prevalence has been suggested as a cause, the reasons for rising stroke incidence in the young are not clear. We explored several alternate explanations: trends in neurologically-focused emergency department (ED) visits, differential diagnostic classification of stroke and TIA over time, and changes in the use of advanced imaging in young and older adults. Methods: We performed a retrospective, serial, cross-sectional study on a nationally representative sample of all ED visits in the United States to quantify changes in patterns of neurologically-focused ED visits, stroke and TIA diagnoses, and rates of MRI utilization for young (18 – 44 years) and older (65+ years) adults over a 17-year period (1995 – 2000; 2005 – 2015) using National Hospital Ambulatory Medical Care Survey (NHAMCS) data. Results: In young adults, 0.4% (95% CI 0.3% – 0.5%) of neurologically-focused ED visits resulted in a primary diagnosis of stroke vs. 6.8% (95% CI 6.2% – 7.5%) for older adults. In both populations, the incidence of neurologically-focused ED visits has increased over time (+111/100,000 population/year, 95% CI +94 – +130 in the young vs. +70/100,000 population/year, 95% CI +34 – +108 in older adults). There was no evidence of differential classification of TIA to stroke over time (OR 1.001 per year, 95% CI 0.926 – 1.083 in the young; OR 1.003 per year, 95% CI 0.982 – 1.026 in older adults) and no evidence of disproportionate rise in MRI utilization for neurologically-focused ED visits in the young (OR 1.057 per year, 95% CI 1.028 – 1.086 in the young; OR 1.095 per year, 95% CI 1.066 – 1.125 in older adults). Conclusions: If the specificity of stroke diagnosis amongst ED visits is similar amongst young and older populations, then the combination of data observed here, including (1) a lower prior probability of stroke diagnoses in the young and (2) an increasing trend in neurologically-focused ED visits in both age groups, suggests that false positive diagnoses will increase over time, with a faster rise in the young compared to older adults. These data suggest a potential explanation that may contribute to higher stroke incidence in the young and merits further scrutiny.

The Epidemiology of Herpes Zoster in the United States During the Era of Varicella and Herpes Zoster Vaccines: Changing Patterns Among Older Adults

2018 ◽  
Vol 69 (2) ◽  
pp. 341-344 ◽  
Author(s):  
Rafael Harpaz ◽  
Jessica W Leung
Keyword(s):  
United States ◽  
Older Adults ◽  
Herpes Zoster ◽  
The United States ◽  
Administrative Databases ◽  
Younger Adults ◽  
Incidence Trends ◽  
Changing Patterns ◽  
Herpes Zoster Incidence

Abstract Historic herpes zoster incidence trends in US adults have been hard to interpret. Using administrative databases, we extended previous descriptions of these trends through 2016. We observed an age-specific transition, with ongoing increases among younger adults but deceleration in older adults. The patterns are not readily explained.

scholarly journals Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan

BMC Cancer ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Dai Shida ◽  
Yuka Ahiko ◽  
Taro Tanabe ◽  
Takefumi Yoshida ◽  
Shunsuke Tsukamoto ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Young Adult ◽  
Stage Iv ◽  
Adult Patients ◽  
Adolescent And Young Adult ◽  
Stage Iv Colorectal Cancer

Public Interest and Behavior Change in the United States Regarding Colorectal Cancer Following the Death of Chadwick Boseman: Infodemiology Investigation of Internet Search Trends Nationally and in At-Risk Areas (Preprint)

2021 ◽  
Author(s):  
Nicholas B Sajjadi ◽  
Kaylea Feldman ◽  
Samuel Shepard ◽  
Arjun K Reddy ◽  
Trevor Torgerson ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
At Risk ◽  
Colon Cancer ◽  
Public Interest ◽  
Black Population ◽  
The United States ◽  
American Cancer Society ◽  
Cancer Society ◽  
Search Volume

BACKGROUND Colorectal cancer (CRC) has the third highest cancer mortality rate in the United States. Enhanced screening has reduced mortality rates; however, certain populations remain at high risk, notably African Americans. Raising awareness among at-risk populations may lead to improved CRC outcomes. The influence of celebrity death and illness is an important driver of public awareness. As such, the death of actor Chadwick Boseman from CRC may have influenced CRC awareness. OBJECTIVE We sought to assess the influence of Chadwick Boseman’s death on public interest in CRC in the United States, evidenced by internet searches, website traffic, and donations to prominent cancer organizations. METHODS We used an auto-regressive integrated moving average model to forecast Google searching trends for the topic “Colorectal cancer” in the United States. We performed bivariate and multivariable regressions on state-wise CRC incidence rate and percent Black population. We obtained data from the American Cancer Society (ACS) and the Colon Cancer Foundation (CCF) for information regarding changes in website traffic and donations. RESULTS The expected national relative search volume (RSV) for colorectal cancer was 2.71 (95% CI 1.76-3.66), reflecting a 3590% (95% CI 2632%-5582%) increase compared to the expected values. With multivariable regression, the statewise RSV increased for each percent Black population by 1.09 (SE 0.18, <i>P</i>&lt;.001), with 42% of the variance explained (<i>P</i>&lt;.001). The American Cancer Society reported a 58,000% increase in CRC-related website traffic the weekend following Chadwick Boseman’s death compared to the weekend before. The Colon Cancer Foundation reported a 331% increase in donations and a 144% increase in revenue in the month following Boseman’s death compared to the month prior. CONCLUSIONS Our results suggest that Chadwick Boseman’s death was associated with substantial increases in awareness of CRC. Increased awareness of CRC may support earlier detection and better prognoses.

scholarly journals Perceived personal deadlines for late-life preparation across adulthood

2020 ◽  
Author(s):  
Frieder R. Lang ◽  
Fiona S. Rupprecht
Keyword(s):  
Older Adults ◽  
Longitudinal Data ◽  
Social Connectedness ◽  
Late Life ◽  
Regression Analyses ◽  
Multilevel Regression ◽  
Younger Adults ◽  
Opportunity Structures ◽  
Self Rated Health ◽  
Over Time

Abstract Throughout adulthood, individuals follow personal timetables of deadlines that shape the course of aging. We examine 6-year-longitudinal data of perceived personal deadlines for starting with late-life preparation across adulthood. Findings are based on a sample of 518 adults between 18 and 88 years of age. Multilevel regression analyses were conducted to explore changes in personal deadlines for preparation in five domains (i.e., finances, end of life, housing, social connectedness, caregiving) in relation to calendar age, self-rated health, subjective position in life, and sociodemographic variables. Findings suggest that personal deadlines for starting preparatory activities differ depending on calendar age and domain of late-life preparation. Older adults as compared to younger adults are likely to report narrower deadlines for beginning with late-life preparation. Perceived deadlines for late-life preparation were furthermore found to be preponed and slightly dilated over time. Findings suggest that depending on age-graded opportunity structures, individuals flexibly adjust their personal deadlines for late-life preparation.

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