School of Population and Global Health, The University of Western Australia, Crawley, WA, 6009, Australia.
Centre for Genetic Origins of Health and Disease, School of Biomedical Sciences, the University of Western Australia, Crawley, WA, 6009, Australia.
Int J Colorectal Dis. 2019 Oct;34(10):1673-1680. doi: 10.1007/s00384-019-03380-5. Epub 2019 Aug 30.
Survival following colorectal cancer (CRC) survival may be influenced by a number of factors including family history, individual medical history, and comorbidities. The impact of these factors may vary based on the patient's age.
The study cohort consisted of individuals born in Western Australia between 1945 and 1996, who had been diagnosed with CRC prior to 2015 (n = 3220). Hospital, cancer, and mortality data were extracted for each patient from state health records and were used to identify potential risk factors associated with CRC survival. Family linkage data, in combination with cancer registry data, were used to identify first-degree family members with a history of CRC. The association between survival following CRC diagnosis and identified risk factors was examined using Cox proportional hazard models.
Age and sex were not significantly associated with survival in young patients. However, in middle-aged patients increasing age (HR 1.03, 95% CI 1.01-1.05, p = 0.003) and being male (HR 0.72, 95% CI 0.60-0.87, p < 0.001) were associated with reduced survival. Being diagnosed with polyps and having a colonoscopy prior to CRC diagnosis were associated with improved survival in both young and middle-aged patients, while a history of non-CRC and liver disease was associated with reduced survival. In middle-aged patients, having diabetes-related hospital admissions (HR 1.53, 95% CI 1.15-2.03, p = 0.004) was associated with reduced survival.
In both young and middle-aged patients with CRC, factors associated with early screening and detection were associated with increased CRC survival while a history of liver disease and non-CRC was associated with decreased CRC survival.
结直肠癌（CRC）患者的生存情况可能受到多种因素的影响，包括家族史、个人病史和合并症。这些因素的影响可能因患者的年龄而异。
研究队列由 1945 年至 1996 年期间出生于西澳大利亚的个体组成，他们在 2015 年之前被诊断患有 CRC（n=3220）。从州健康记录中提取每位患者的医院、癌症和死亡数据，以确定与 CRC 生存相关的潜在危险因素。结合癌症登记数据，使用家族关联数据确定有 CRC 病史的一级亲属。使用 Cox 比例风险模型检查 CRC 诊断后生存与确定的危险因素之间的关联。
年龄和性别与年轻患者的生存无显著相关性。然而，在中年患者中，年龄的增加（HR 1.03，95%CI 1.01-1.05，p=0.003）和男性（HR 0.72，95%CI 0.60-0.87，p<0.001）与生存降低相关。在年轻和中年患者中，诊断为息肉和在 CRC 诊断前进行结肠镜检查与生存改善相关，而非 CRC 和肝脏疾病的病史与生存降低相关。在中年患者中，与糖尿病相关的住院治疗（HR 1.53，95%CI 1.15-2.03，p=0.004）与生存降低相关。
在年轻和中年 CRC 患者中，与早期筛查和检测相关的因素与 CRC 生存增加相关，而肝脏疾病和非 CRC 的病史与 CRC 生存降低相关。
