Patterns of colorectal cancer diagnosis among younger adults in a real-world, population-based cohort

2021 ◽  
pp. 00-00
Author(s):  
Omar Abdel-Rahman ◽  
Hatim Karachiwala ◽  
Sheryl Koski
Keyword(s):  
Colorectal Cancer ◽  
Early Onset ◽  
Population Based ◽  
Age At Diagnosis ◽  
Administrative Databases ◽  
Multivariable Logistic Regression Analysis ◽  
World Population ◽  
Factors Associated ◽  
Younger Age ◽  
South Zone

Aims: To review the patterns of early-onset (<50 years old) colorectal cancer (CRC) in Alberta across the past 15 years among different socioeconomic and demographic patient subgroups. Methods: This is a retrospective, population-based study based on Alberta administrative databases. Income level was identified via income information from the 2006 Canadian census. Patients with colorectal adenocarcinoma diagnosed 2004–2018 were included. Frequency analyses were used to examine the percentage of early-onset CRC cases among different subgroups over the period studied. Multivariable logistic regression analysis was used to examine factors associated with the development of early-onset CRC. Results: A total of 24,912 patients were included, of whom 2096 (8.4%) were diagnosed at age <50 years and 22,816 (91.6%) at age ≥50 years. The percentage of patients diagnosed at age <50 years increased over time (10.2% in 2018 vs 7.9% in 2004; p < 0.003). Higher income was associated with younger age at diagnosis of CRC (odds ratio [OR] for quartile 1 vs quartile 4: 0.54; 95% CI: 0.47–0.62). Other factors associated with younger age at diagnosis included female sex (OR for male vs female: 0.85; 95% CI: 0.78–0.94), distal CRC (OR: 1.66; 95% CI: 1.50–1.84) and North zone (OR for South zone vs North zone: 0.74; 95% CI: 0.60–0.92). Conclusion: The proportion of patients (out of the overall CRC population) with early-onset CRC, increased in Alberta throughout the study duration (particularly left-sided CRC). There is a need to reassess the current age limits for CRC screening in Canada in view of these findings.

scholarly journals A Review of Colorectal Cancer in Terms of Epidemiology, Risk Factors, Development, Symptoms and Diagnosis

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2025
Author(s):  
Tomasz Sawicki ◽  
Monika Ruszkowska ◽  
Anna Danielewicz ◽  
Ewa Niedźwiedzka ◽  
Tomasz Arłukowicz ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Physical Inactivity ◽  
Ecological Factors ◽  
Population Based ◽  
Review Article ◽  
Therapeutic Interventions ◽  
Factors Associated ◽  
Hereditary Factors ◽  
Disease Stages

This review article contains a concise consideration of genetic and environmental risk factors for colorectal cancer. Known risk factors associated with colorectal cancer include familial and hereditary factors and lifestyle-related and ecological factors. Lifestyle factors are significant because of the potential for improving our understanding of the disease. Physical inactivity, obesity, smoking and alcohol consumption can also be addressed through therapeutic interventions. We also made efforts to systematize available literature and data on epidemiology, diagnosis, type and nature of symptoms and disease stages. Further study of colorectal cancer and progress made globally is crucial to inform future strategies in controlling the disease’s burden through population-based preventative initiatives.

Adherence to clinical practice guidelines for adjuvant chemotherapy for colorectal cancer in Uruguay: A population-based study.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 53-53
Author(s):  
Santiago Fontes ◽  
Ana Marín-Jiménez ◽  
Megan Berry ◽  
Mauricio Cuello ◽  
Juan Carlos Sánchez ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Population Based ◽  
Stage Iii ◽  
Disease Stage ◽  
Curative Intent ◽  
Factors Associated

53 Background: Despite surgery, the 5-year risk of systemic recurrence of colorectal cancer (CRC) in the absence of any further therapy is approximately 50 % for those with lymph node involvement and 20 ─ 30 % if the lymph nodes are negative. Adjuvant chemotherapy contributes to improved disease-free and overall survival for node-positive (stage III) or high-risk node negative (stage IIB) colon cancer. Similar benefits are observed for adjuvant chemoradiotherapy in rectal cancer. Previous research shows varied rates of adherence to published adjuvant chemotherapy Clinical Practice Guidelines (CPGs) for CRC, although population-based data is scarce. Purpose: The aim of this analysis was to assess adherence rates to adjuvant chemotherapy prescription within 16 weeks of surgery according to local and international CPGs for CRC patients treated with curative intent between 2008 and 2019 at the Uruguayan National Cancer Institute. Data regarding factors associated with chemotherapy receipt beyond 16 weeks from surgery and chemotherapy non receipt was also retrieved and analysed. Methods: We retrospectively reviewed medical and pathology reports of 833 patients diagnosed with CRC at our institution. Patients with stages IIB or III CRC who underwent curative-intent surgery were identified and included in the present analysis. A 16-week benchmark timeline for treatment initiation from date of surgery was considered. Fisher’s exact test was used to determine factors independently associated with receipt of chemotherapy and meeting the 16-week benchmark (p 0.05). Results: A total of 400 patients were identified of which 72% had peritoneal colorectal tumors and 28% had sub-peritoneal rectal tumors. Approximately 70% of the latter group received neoadjuvant chemo-radiotherapy. Considering the total cohort, 61% received adjuvant chemotherapy. Factors predicting chemotherapy receipt in the peritoneal colorectal group were age ≤ 70 and stage III disease. In the sub-peritoneal rectal group no significant effect was found. The 16-week benchmark was met in 72% (175) of those receiving chemotherapy and 70.6% (167) completed 6 months of systemic adjuvant treatment. A total of 156 patients (39%) did not receive adjuvant chemotherapy. The factors predicting chemotherapy non receipt were age > 70 and stage IIB in the peritoneal colorectal group. Conclusions: This analysis of adherence to CPGs identified several factors associated with chemotherapy non receipt and chemotherapy receipt outside of timeline benchmarks from date of curative-intent surgery in Montevideo, Uruguay. The two main factors significantly associated with chemotherapy non receipt were advanced age and lower disease stage. To our knowledge, our data is the first to elucidate these specific factors in the Uruguayan CRC patient population.

Improved Prognosis in Multiple Myeloma-a Population Based Study on 13,376 Patients Diagnosed in Sweden 1973–2001.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2408-2408
Author(s):  
Sigurdur Y. Kristinsson ◽  
Ola Landgren ◽  
Paul Dickman ◽  
Asa Derolf ◽  
Magnus Bjorkholm
Keyword(s):  
Multiple Myeloma ◽  
Excess Mortality ◽  
Relative Survival ◽  
Population Based ◽  
Age At Diagnosis ◽  
University Hospital ◽  
Calendar Period ◽  
Population Based Study ◽  
Younger Age ◽  
One Year

Abstract Background: Over the last decades there have been advances in the treatment of patients with multiple myeloma (MM) and prognosis has improved with the introduction of new treatment strategies. However, few studies have addressed the issue which patients benefit most from these therapeutic changes over the years. Aims: To evaluate relative survival in all diagnosed MM patients in Sweden 1973–2001 and relate the changes to age, sex and type of hospital where diagnosis was made. Methods: All patients with MM notified to the Swedish Cancer Register in 1973–2001 were followed up by record linkage to the nationwide Cause of Death Register. Survival analyses were performed by obtaining relative survival (RS) defined as the ratio of observed versus expected survival. The study period was divided arbitrarily to four calendar periods: 1973–1979, 1980–1986, 1987–1993, and 1994–2002. Patients were grouped according to age at diagnosis (0–40, 41–50, 51–60, 61–70, 71–80, and 80+), sex, and hospital category. RS was estimated using SAS (Cary, NC, USA) and excess mortality modelled using Poisson regression. Results: A total of 13,376 patients (7,114 males and 6,262 females, mean age 69.8 years, and 32% diagnosed at a university hospital) were diagnosed with MM in Sweden between January 1st 1973 and December 31st 2001. The overall one-year RS estimates were 73%, 78%, 80%, and 81%, respectively, for the four calendar periods. The overall five-year RS was 31%, 32%, 34%, and 36% and the ten-year RS remained stable at 12%, 11% 13% in the first three periods; ten-year RS could not be calculated for the last calendar period. The increase in one-year RS was observed in all age categories over the four calendar periods, while the increase in five-year RS was restricted to patients <70 years. Younger age at onset was associated with a superior survival in all calendar periods. Differences in survival by age at diagnosis and calendar period were highly statistically significant (p<0.0001). Females had a superior 1- (p=0.002), 5- (p=0.024), and 10-year RS (p=0.019) compared to males, after adjusting for age and period. Patients diagnosed at university hospitals had superior 5- and 10-year RS (p=0.007) but not 1-year RS. Summary/conclusions: The present study shows an improved prognosis over time in a population-based study including > 13,000 MM patients diagnosed during a 29-year period. Of interest is that even one-year RS has improved in all age groups over the whole study period. Increase in five-year RS was only observed in patients aged <70 years. The ten-year RS did not improve over the first 20 years and could not be estimated for patients diagnosed in the last period. Younger age at diagnosis was associated with superior one-, five- and ten-year RS in all calendar periods. Females had a significantly better survival than males. A significant difference in survival was seen according to type of hospital, with patients diagnosed at a university hospital surviving longer. In conclusion, the results show that survival of MM patients has improved during the study period. However, long-term survival has not improved significantly. Males, elderly patients and patients diagnosed during early calendar periods experienced higher excess mortality.

Level and Factors Associated with Participation in PopulationBased Cancer Screening in Safranbolu District of Karabuk, Turkey

2020 ◽  
Author(s):  
Raziye ÖZDEMIR ◽  
Fatma TÜRKMEN ÇEVIK ◽  
Duygu KES ◽  
Merve KARACALI ◽  
Simge ÖZGÜNER
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Fold Increase ◽  
Population Based ◽  
Colorectal Cancers ◽  
Binary Logistic Regression Model ◽  
Cross Sectional ◽  
Factors Associated

Background: Cervix, breast and colorectal cancers are included in the national population-based screening (PBS) program in Turkey. This study aimed to assess participation in PBSs for these cancers and to identify factors associated with participation in screenings in Safranbolu district of Karabuk, Turkey in 2016-2017. Methods: In this cross-sectional study, separate studying groups for cervix, breast and colorectal cancers were identified, taking into account the target age range specified in the national screening standards. The sample size was determined to be 374 for cervical cancer, 371 for breast cancer and 373 for colorectal cancer in the Epi-Info StatCalc program with a prevalence of 50%, a 95% Confidence Interval (CI) and a 5% error margin. The results of the data collected through face-to-face interview using questionnaires were evaluated with Chisquare tests (P<0.05) and included in the binary logistic regression model. Results: Participation in PBS at least once between 2011 and 2016 years was 26.2% for cervical cancer, 27.6% for breast cancer and 31.6% for colorectal cancer, whereas the level of PBS or opportunistic screening at least once was 51.1%, 42.7% and 32.2%, respectively. A 2.9-fold increase in participation for the cervical cancer screening was associated with informing women about cervical cancer by the family physicians. Being married and living in the district center showed associations with a higher rate of participation for colorectal cancer screening. Conclusion: Participation in PBS was low for the 5.5-year period. More effort is needed to increase the effectiveness of the program.

scholarly journals Molecular Features and Methylation Status in Early Onset (≤40 Years) Colorectal Cancer: A Population Based, Case-Control Study

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Giulia Magnani ◽  
Daniela Furlan ◽  
Nora Sahnane ◽  
Luca Reggiani Bonetti ◽  
Federica Domati ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mismatch Repair ◽  
Early Onset ◽  
Methylation Status ◽  
The Elderly ◽  
Population Based ◽  
Repair System ◽  
Molecular Features ◽  
A Minor ◽  
Early Onset Colorectal Cancer

Colorectal cancer is usually considered a disease of the elderly. However, a small fraction of patients develops colorectal cancer earlier. The aim of our study was to define the frequency of known hereditary colorectal syndromes and to characterise genetic and epigenetic features of early nonhereditary tumors. Thirty-three patients ≤40 years with diagnosis of colorectal cancer and 41 patients with disease at >60 years of age were investigated for MSI, Mismatch Repair proteins expression,KRASandBRAFmutations, hypermethylation, and LINE-1 hypomethylation. Detection of germline mutations was performed in Mismatch Repair,APCandMUTYHgenes. Early onset colorectal cancer showed a high incidence of hereditary forms (18%).KRASmutations were detected in 36% of early nonhereditary tumors. Early onset colorectal cancer disclosed an average number of methylated genes significantly lower when compared to the controls (p=0.02). Finally both of the two groups were highly methylated inESR1,GATA5, andWT1genes and were similar for LINE-1 hypomethylation. The genetic make-up of carcinomas differs from young to elderly patients. Early onset tumors showed more frequently a constitutional defective of Mismatch Repair System and a minor number of methylated genes. Hypermethylation ofESR1,GATA5, andWT1genes suggests possible markers in the earlier diagnosis of colorectal tumorigenesis.

scholarly journals Risk Factors Associated With Early-Onset Colorectal Neoplasm in Chinese Youth: A Prospective Population-Based Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Jie Shen ◽  
Yiling Wu ◽  
Miao Mo ◽  
Xiaoshuang Feng ◽  
Changming Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Onset ◽  
Primary Care Physicians ◽  
Screening Program ◽  
Colorectal Neoplasm ◽  
Population Based ◽  
Logistic Regression Models ◽  
Crc Screening ◽  
Factors Associated ◽  
Potential Risk Factors

Evidence of the risk factors associated with early-onset colorectal neoplasm from prospective population-based studies is limited. We enrolled 17,293 participants younger than 50 years from the Shanghai colorectal cancer (CRC) screening program cohort. Face-to-face interviews were performed by trained primary care physicians using a standardized questionnaire to collect the information on potential risk factors at baseline entry. Furthermore, 124 cases of early-onset colorectal neoplasm, including six CRC cases and 118 colorectal adenoma (CRA) cases, were detected between 2012 and 2016. Multivariable logistic regression models and restricted cubic spline (RCS) were used to evaluate the risk factors associated with early-onset colorectal neoplasm. We found that sex, body mass index (BMI), and family history of CRC were associated with the early onset of colorectal neoplasm. The RCS model showed a positive dose–response and linear association between BMI and risk of early-onset colorectal neoplasm among young participants (p-overall = 0.19, p-nonlinear = 0.97). The findings indicated that it was beneficial for normal people younger than 50 years to start opportunistic CRC screening. As for those at high risk, increased surveillance is strongly recommended. Further close follow-up is required for research on the underlying causes of early-onset CRC.

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