Jaclyn Malat, DO1, Sarah Martin, BS1, Adrian Ong, MD2, Michael Brown, MD, MBA, FACS2. 1Philadelphia College of Osteopathic Medicine, 2Reading Hospital, Tower Health
Objective: The aim of this study is to compare stage and mortality in colorectal cancer (CRC) patients above and below age 50. We hypothesize that the stage at diagnosis and mortality will both be higher in patients under age 50. Recent national reports show an increase in CRC diagnoses in younger patients. This correlates with the recent change by the American Cancer Society to beging screening colonoscopies at age 45, instead of age 50. Data on this younger patient population, including stage of diagnosis and mortality however, are limited and require further investigation.
Methods: A 20-year retrospective review of electronic medical records was completed at the McGlinn Cancer Institute from 1997 to 2017 of all patients diagnosed with CRC. This data was then aggregated by age, gender, tumor location, stage and mortality over the past 20 years. Univariate analysis of variables was performed where appropriate. Statistical significance was indicated by a p value of 0.05.
Results: Of 3041 patients diagnosed with CRC over the last 20 years, 231 (7.6%) patients were below age 50. These younger patients were diagnosed at higher stages compared to patients age 50 and above; 71.4% (165/231) of younger patients compared to 56.5% (1589/2810) of those above age 50 were diagnosed at stage 2 or higher (p<0.0001). Despite this, the mortality rate over 20 years in younger patients was lower compared to those above age 50 (35.5% vs 59.3%, p = 0.0001). There was no statistically significant difference in gender or location of tumor between these two age groups.
Conclusion: Although patients under age 50 were more likely to be diagnosed at higher stages of CRC, they demonstrated a lower mortality rate when compared to patients above age 50. Based on our data, initiating screening colonoscopies at age 45 would likely downgrade the stage at diagnosis however, its effect on overall survival has yet to be determined.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95127
Program Number: P286
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster