Ulanja Mark B, Beutler Bryce D, Rishi Mohit, Ogala Chioma, Patterson Darryll R, Gullapalli Nageshwara, Ambika Santhosh
Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89557, USA.
Renown Institute for Cancer, 1155 Mill Street, W-11, Reno, NV 89502, USA.
Cancers (Basel). 2018 Nov 28;10(12):472. doi: 10.3390/cancers10120472.
Emerging evidence suggests that the incidence of colorectal cancer is increasing among individuals under the age of 50 years. However, the pattern of disease presentation in young patients remains under investigation. This is a retrospective cohort study of patients diagnosed with colorectal cancer (CRC) between 2004 and 2015. Data was acquired from the Surveillance, Epidemiology, and End Results 18 program registries. A total of 269,398 patients who met the inclusion criteria were included in the final analysis. The primary outcomes were the likelihood of metastatic disease at diagnosis and survival. Of the 269,389 patients diagnosed with CRC, 11.8% of the patients were young (20 to 49 years), 45.6% were middle-aged (50 to 69 years), and 42.6% were elderly (70 years or older). Individuals in the middle-aged and elderly cohorts were significantly less likely to present with metastatic disease as compared to the young cohort (middle-aged adjusted odds ratio (aOR) = 0.73, 95% confidence interval (CI) = 0.70 to 0.75, elderly aOR = 0.49, 95% CI = 0.47 to 0.50). However, overall survival was longest in the young cohort. We conclude that young individuals with colorectal cancer have an increased risk of presenting with distant metastases as compared to the middle-aged and elderly, but, nevertheless, exhibit prolonged survival.
新出现的证据表明，50岁以下人群中结直肠癌的发病率正在上升。然而，年轻患者的疾病表现模式仍在研究中。这是一项对2004年至2015年间被诊断为结直肠癌（CRC）患者的回顾性队列研究。数据来自监测、流行病学和最终结果18项目登记处。共有269398名符合纳入标准的患者被纳入最终分析。主要结局是诊断时发生转移性疾病的可能性和生存率。在269389名被诊断为CRC的患者中，11.8%为年轻人（20至49岁），45.6%为中年人（50至69岁），42.6%为老年人（70岁及以上）。与年轻队列相比，中年和老年队列中的个体出现转移性疾病的可能性显著降低（中年调整优势比（aOR）=0.73，95%置信区间（CI）=0.70至0.75，老年aOR=0.49，95%CI=0.47至0.50）。然而，年轻队列的总生存期最长。我们得出结论，与中年人和老年人相比，患有结直肠癌的年轻人出现远处转移的风险增加，但尽管如此，其生存期延长。
