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Do Young Colon Cancer Patients Have Worse Outcomes?

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Abstract

Previous studies on colon cancer have noted rising incidence rates among young individuals and suggest that they may have more aggressive disease and worse 5-year survivals than their older counterparts. Our study uses a nationwide population-based cancer registry to analyze colon cancer presentations and outcomes in a young versus an older population. The records of patients with colon carcinoma were obtained from the Surveillance, Epidemiology, and End Results (SEER) national cancer database (1991–1999). Two cohorts based on age at diagnosis (20–40 years, n = 1334 vs. 60–80 years, n = 46,457) were compared for patient and tumor characteristics, treatment, and 5-year cancer-specific survival. A multivariate Cox regression was performed to identify predictors of survival. The young group had a higher proportion of black and Hispanic patients than did the older group (p < 0.001). Young patients had less stage I or II disease, more stage III or IV disease (p < 0.001), and worse-grade (poorly differentiated or anaplastic) tumors (p < 0.001). The 5-year stage-specific survival was similar for stage I and III disease (p = NS) but was significantly better for young patients with stage II and IV disease (p < 0.01). Using a nationally representative cancer registry, we found that young colon cancer patients tend to have later-stage and higher-grade tumors. However, they have equivalent or better 5-year cancer-specific survival compared to older patients. This population-based finding contradicts prior single-institution reports.

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Acknowledgment

This study was supported in part by an American Society of Colon and Rectal Surgeons Limited Project Grant.

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Authors and Affiliations

  1. Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, Room 72-215 CHS, 90095, Los Angeles, California, USA

    Jessica B. O’Connell M.D., Melinda A. Maggard M.D., Jerome H. Liu M.D., David A. Etzioni M.D. & Clifford Y. Ko M.D., M.S.H.S.

  2. Department of Surgery, Veterans Administration Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Building 500, 90073, Los Angeles, California, USA

    Jessica B. O’Connell M.D., Melinda A. Maggard M.D., Jerome H. Liu M.D. & Clifford Y. Ko M.D., M.S.H.S.

  3. Department of Surgery, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Room E7-126, 75390-9156, Dallas, Texas, USA

    Edward H. Livingston M.D.

Authors
  1. Jessica B. O’Connell M.D.
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  2. Melinda A. Maggard M.D.
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  3. Jerome H. Liu M.D.
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  4. David A. Etzioni M.D.
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  5. Edward H. Livingston M.D.
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  6. Clifford Y. Ko M.D., M.S.H.S.
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Correspondence to Jessica B. O’Connell M.D..

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O’Connell, J., Maggard, M., Liu, J. et al. Do Young Colon Cancer Patients Have Worse Outcomes?. World J. Surg. 28, 558–562 (2004). https://doi.org/10.1007/s00268-004-7306-7

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  • DOI: https://doi.org/10.1007/s00268-004-7306-7

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