ASCO 2014 Report – Younger colon cancer patients diagnosed with more advanced disease, but have better survival rates at all stages

by Bruce Sylvester – Colon cancer patients diagnosed before age 50 have more advanced stages of colon cancer at diagnosis but have better survival at all stages of disease.  Researchers reported these findings in a poster presentation at ASCO 2014.

As background, the authors noted, “There has been an increased incidence of colon cancer (1.6%) in YP [young patients under 50 years], but they are underrepresented in research studies. The aim of our study is to compare characteristics of colon cancer and survival outcome in YPs (18-49 years) vs older patients (>50) using the Surveillance, Epidemiology, and End Results (SEER) database.”

Using the database (1991-2010), the investigators reviewed data on 375,443 patients over 18 years of age with colon cancer.

They used standard statistical tools to evaluate for risk-adjusted outcomes, predict hazard of dying and to estimate survival.

They reported that young patients were more likely to show distant metastasis than older patients (27.7% vs 19.1%; p<0.001) and had more poorly differentiated tumors (20.3 % vs 18.0%; p< 0.001).

Compared to older patients, young patients in this study had more cancer surgery (92.6 % vs 91%; p<0.001).

Comparative five year survival were better for younger patients in all stages of disease — for localized disease 95.6% vs. 91.1%, for regional disease 76.7% vs 72.8%, for distant disease 20.3% vs. 16.8% and for un-staged disease 69.3% vs. 50.4%.

Controlling for gender, race, marital status, grade, stage, cancer specific surgery and post-operative radiation, the investigators determined that age is an independent predictor of death in colon cancer. Younger patients in this study had a statistically significantly lower risk of dying (HR 0.767; p<0.001).

The authors concluded, “Previous studies of YPs [young patients] with colon cancer were found to have either equivalent or better survival in stages II and IV compared to older patients. Our study shows that young patients less than 50 years of age have more advanced stages of colon cancer at diagnosis but have better stage specific survival in all stages.”

Citation: 2014 ASCO Annual Meeting: General Poster Session, Gastrointestinal (Colorectal) Cancer: Abstract Number 3585