Maria S Altieri, MD, MS1, Hannah Thompson, MD2, Aurora Pryor, MD1, Jie Yang, MD2, Siao Sun, BS2, Konstantinos Spaniolas, MD2, Mark Talamini, MD, MBA2, Jill Genua, MD2. 1Washington University School of Medicine, 2Stony Brook University Hospital
Introduction: The American Cancer Society recently lowered the recommended age for screening of colorectal cancer (CRC) to age 45 due to recent data showing increased incidence of CRC in younger populations. The purpose of this study was to evaluate if younger patients have increased likelihood of resection for CRC (CRR) through the use of a statewide longitudinal database.
Methods: The New York SPARCS administrative database was used to identify all patients with diagnosis of colon cancer from 2000-2016. Through the use of ICD-9 and ICD-10 procedure codes, patients undergoing colorectal resections were identified. Patients were divided into seven age groups: 21-30, 31-40, 41-50, 51-60, 61-70, 71-80 and >80. Patients’ characteristics, demographics, co-morbidities, and complications were evaluated. Duplicate records, missing information, and age< 21 were excluded from analysis. For multiple procedures, only the first procedure was included in the analysis. Chi-square test was used to compare patients’ characteristics, comorbidities and complications among age groups. The linear trend of colon resection in different age groups over years was examined using log-linear Poisson regression models with year as an explanatory variable. Relative risks (RR) with 95% confidence interval were reported.
Results: Following inclusion and exclusion criteria, there were 73,697 colon resection surgeries extracted from 2000 to 2016. Trends are shown on Figure 1. Younger age was significantly associated with increased CRR over time. Patients age 21-70 had a significantly increasing trend over the years (age group 21-30: RR=1.06, p-value<0.0001; age group 31-40: RR 1.04, p<0.0001; age group 41-50: RR 1.04, p<0.0001; age group 51-60: RR 1.02. p<0.0001); age group 61-70: RR 1.01, p=0.0012). Patient age >70 was significantly associated with decreasing trend of CRR over the years (age group 71-80: RR0.98, p<0.0001 an age group > 80: RR 0.99, p-value<0.0001).
Conclusion: Over the years, younger patients have an increased trend of undergoing colorectal resections, with up to a 6% yearly increase over the studied period. New screening initiation guidelines should be considered and awareness among clinicians and the general public should be increased. 
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94509
Program Number: P303
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster