Differences in disease characteristics in young vs older adults with colorectal carcinoma.

Abstract

34 Background: Colorectal carcinoma (CRC) exhibits distinct disease characteristics between younger (≤50 years) and older (>50 years) adults, which may significantly influence treatment decisions and outcomes. This study aims to investigate differences in disease characteristics of colorectal carcinoma among patients aged ≤50 years compared to those aged >50 years, utilizing data from the Surveillance, Epidemiology, and End Results (SEER) database. Methods: A retrospective analysis was performed using the SEER database covering the years 2000 to 2020. A total of 150,000 diagnosed CRC cases were included. Key variables analyzed comprised stage at diagnosis, tumor grade, histological subtype, and 5-year survival rates. Rates of CRC diagnoses in various age brackets were calculated for three time periods: 2000-2010, 2010-2020, and overall from 2000-2020. Results: Within the total cohort, 12% (18,000 cases) were diagnosed in young adults, while 88% (132,000 cases) were in older adults. An analysis of age-specific rates showed: 2000-2010 : Young adults (≤50 years) represented 10% of CRC cases, with 16% presenting at advanced stages (Stage III or IV). 2010-2020 : This group increased to 12%, with 65% diagnosed at advanced stages (Stage III or IV), compared to 52% in older adults (p < 0.001). In terms of tumor characteristics, poorly differentiated tumors were more prevalent in young adults (28% vs. 18%, p < 0.001). The prevalence of microsatellite instability-high (MSI-H) tumors was significantly greater in young adults at 18%, compared to 12% in older adults (p < 0.05). The 5-year overall survival rate for young adults was 68%, notably higher than the 48% for older adults (p < 0.001). Conclusions: This study underscores significant differences in disease characteristics between young and older adults with colorectal carcinoma. Young patients are more likely to present with advanced disease but have better survival outcomes. These findings indicate the necessity for an age specific approach to screening and treatment strategies. Differences in stage at diagnosis, tumor grade, presence of MSI-H, and survival outcomes between younger and older adults diagnosed with colorectal carcinoma. Category Young Adults (≤50 years) Older Adults (>50 years) p-value Proportion of Total CRC Cases 12% (18,000 cases) 88% (132,000 cases) Advanced Stage (Stage III or IV) 65% (2010-2020) 52% (2010-2020) < 0.001 Poorly Differentiated Tumors 28% 18% < 0.001 Microsatellite Instability-High (MSI-H) 18% 12% < 0.05 5-Year Overall Survival Rate 68% 48% < 0.001