Many colorectal cancer patients are younger than the recommended screening age

January 25, 2016

In a recent analysis of US data, one in seven colorectal patients was younger than 50 years old, the recommended age to begin screening. Younger patients were more likely to be diagnosed with advanced stage disease; however, they received more aggressive therapy and lived longer without a cancer recurrence, suggesting some compensation for their later diagnosis. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings raise questions concerning how younger adults' risk of developing colorectal cancer should be assessed, and whether or not they should be screened.

Colorectal cancer has traditionally been considered a disease of the elderly, but the proportion of cases in younger individuals is increasing. To assess the treatment patterns and outcomes of these patients, a team led by Samantha Hendren, MD, MPH, of the University of Michigan, conducted a population-based retrospective study of the nationally representative Surveillance, Epidemiology, and End Results registry, looking specifically at information on patients diagnosed with colorectal cancer in the United States from 1998 to 2011.

Of 258,024 colorectal patients, 37,847 (nearly 15 percent) were younger than 50 years old, the age at which screening begins in the US. (To put this in context, breast cancer screening often begins at age 40, and less than 5 percent of invasive breast cancers occur in women under that age.) Young colorectal patients were more likely to be diagnosed with regional or distant disease, which are both more dangerous than localized disease. Among colorectal cancer patients with distant metastasis, those who were younger were more likely to receive surgical therapy for their primary tumor (72 percent versus 63 percent of older patients). Also, radiation therapy was used more often in younger than in older rectal cancer patients (53 percent versus 48 percent).

Overall, colorectal cancer patients who were younger than 50 years old lived slightly longer without a cancer recurrence, even though they tended to have more advanced disease when they were diagnosed. The 5-year cancer-specific survival for younger patients was 95.1 percent versus 91.9 percent for patients 50 and older for localized disease, 76 percent versus 70.3 percent for regional disease, and 21.3 percent versus 14.1 percent for distant disease, respectively.

"This study is really a wake-up call to the medical community that a relatively large number of colorectal cancers are occurring in people under 50. In a practical sense, this means that we should look out for warning signs of colorectal cancer such as anemia, a dramatic change in the size or frequency of bowel movements, and dark blood or blood mixed with the stool in bowel movements," said Dr. Hendren. "Also, people with a positive family history for colorectal cancer (in first-degree relatives such as parents or siblings) and some others who are at higher risk should begin screening earlier than 50. This is already recommended, but we don't think this is happening consistently, and this is something we need to optimize."
-end-
Article: "Colorectal Cancer Outcomes and Treatment Patterns in Patients Too Young for Average-Risk Screening." Zaid Abdelsattar, Sandra Wong, Scott Regenbogen, Diana Jomaa, Karin Hardiman, and Samantha Hendren. CANCER; Published Online: Jan. 25, 2016 (DOI: 10.1002/cncr.29716).

URL Upon Publication:http://doi.wiley.com/10.1002/cncr.29716

Author Contact: Nicole Fawcett, Manager of Cancer Communications at the University of Michigan Comprehensive Cancer Center, at nfawcett@umich.edu or 1-734-764-2220.

CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online at http://wileyonlinelibrary.com/journal/cancer.

Follow us on Twitter @JournalCancer and Facebook https://www.facebook.com/ACSJournals

About Wiley

Wiley is a global provider of knowledge and knowledge-enabled services that improve outcomes in areas of research, professional practice and education. Through the Research segment, the Company provides digital and print scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising. The Professional Development segment provides digital and print books, online assessment and training services, and test prep and certification. In Education, Wiley provides education solutions including online program management services for higher education institutions and course management tools for instructors and students, as well as print and digital content. The Company's website can be accessed at http://www.wiley.com.

Wiley

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.