The importance of time to treatment in early onset colon cancer: A National Cancer Database analysis.

Abstract

e15708 Background: The incidence of colorectal cancer is on the rise among adults under the age of 50. As a largely unscreened population, they are at risk of clinically significant delays in receiving treatment. In this study, we utilize an administrative dataset to identify the factors that contribute to the delayed time-to-treatment (TTT) among young adults diagnosed with colon cancer. Methods: Patients with colon cancer of all stages were included from the National Cancer Data Base (2010-20), who either underwent surgery or neoadjuvant therapy. Early onset colon cancer (EOCC) was defined as age at diagnosis below 50 years. TTT was defined as the duration between the tissue diagnosis and the first treatment. TTT was categorized into early and delayed groups based on the median TTT. Patients treated within 7 days were excluded to eliminate patients receiving emergency procedures. Results: A total of 15,004 patients met inclusion criteria. The median TTT was 22 days. More than two-thirds of patients were of ages 40 to 49 and of good functional status (Charlson Deyo score [CDS] 0). On multivariable logistic regression analysis, factors associated with delay beyond the median TTT included older age (age 30-39 versus 40-49, odds ratio [OR]: 0.88), male gender (OR: 1.09), Black race (OR: 1.34), Hispanic ethnicity (OR: 1.28), poor functional status (CDS 1 and 2, versus 0, OR: 1.12, 1.55), Medicaid (OR: 1.27) and Medicare insurance (OR: 1.5), lower educational area of residence (OR: 1.11), and lower stage of disease at diagnosis (Stage II-IV versus stage I, OR: 0.62, 0.64, 0.53). Conclusions: More than 1% of patients with EOCC have TTT exceeding four months. By identifying sociodemographic factors associated with delayed TTT, we can enhance treatment strategies tailored to this specific patient population.