Younger Colon Cancer Patients Have Higher Survival Rates

Based on a recent study, younger patients with colorectal cancer were more likely to present advanced-stage tumors at diagnosis and metastasize much sooner. However, these same patients had better than or equal survival to patients 50 and older, according to data presented at the 2012 American Society of Clinical Oncology Annual Meeting.

“We’re seeing more advanced tumors in this population because the cases aren’t being caught early enough,” said study leader Edith Mitchell, MD, a clinical professor in the Department of Medical Oncology at Jefferson Medical College of Thomas Jefferson University. “Screening isn’t recommended until age 50, and the younger a patient is, the more likely they are to ignore symptoms of more advanced stages of the disease.”

Mitchell, who is also director of the newly established Center to Eliminate Cancer Disparities at Jefferson’s Kimmel Cancer Center, and her colleagues obtained data from the tumor registry of Thomas Jefferson University Hospital (TJUH). They compared data on 4595 patients treated for colorectal cancer from 1988 to 2007 with data obtained from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database on 290,338 patients with colorectal cancer treated from 1988 to 2004. The researchers collected data on location, stage, and histologic grade of the cancer.

Researchers found that in both data sets (SEER and TJUH), patients under age 50 with colorectal cancer presented with more advanced-stage tumors and had more poorly differentiated tumors than older patients. Patients under 50 also had more mucinous/signet-ring cell tumors, with 12% to 8.1% in the TJUH data and 13.2% to 10.3% in the SEER data, with younger males having the highest prevalence in both data sets.

Younger patients were more likely to have positive nodes at all stages and had fewer right-side tumors relative to patients 50 and over. According to the data, patients under 50 had a higher proportion of rectal tumors. Patients under age 50 were also more likely to develop peritoneal metastases but less likely to have lung metastases than older patients.

Patients under age 50 had better than or equal survival to those 50 and older, despite their poor pathologic features. This may in part be explained by their overall health. Early evidence suggests that younger patients are able to tolerate more aggressive cancer therapies because of fewer comorbidities, said coauthor Scott Goldstein, MD, of Jefferson’s Department of Surgery.

“Ongoing studies will help clarify the survival disparity and assess differences in treatment and molecular features between younger and older colorectal cancer patients,” Mitchell said.

Source: Jefferson Kimmel Cancer Center.