Although it is generally believed that young patients with rectal cancer have worse survival rates, no comprehensive analysis has been reported.
Dr Connell and colleagues from Los Angeles, America used a national-level, population-based cancer registry to compare rectal cancer outcomes between young versus older populations.
The researchers evaluated all patients with rectal carcinoma in the Surveillance, Epidemiology, and End Results cancer database from 1991 to 1999.
The research team included young (20–40 years; n = 466) and older groups (60–80 years; n = 11,312), with a mean age of 34.1 and 70 years, respectively.
The team compared the young and older groups for patient and tumor characteristics, treatment patterns, and 5 year overall and stage-specific survival.
| Young patients were more likely to present with late-stage disease|
|Diseases of the Colon & Rectum|
The investigators performed cox multivariate regression analysis to identify predictors of survival.
The researchers reported that the young group was comprised of more black and Hispanic patients compared with the older group.
The team found that young patients were more likely to present with late-stage disease.
Younger versus older patients at Stage 3 of the disease were 27% versus 20% respectively, and at Stage 4, 17% versus 14% respectively.
The researchers reported that 24% of the younger group also had worse grade tumors compared to 14% of the older group.
The team noted that although the majority or 85% of both groups received surgery, significantly more young patients received radiation.
In addition, the research team showed that overall and stage-specific, 5 year survival rates were similar for both groups.
The researchers reported that previous studies have found young rectal cancer patients to have poorer survival compared with older patients.
Dr Connell commented, “This population-based study shows young rectal cancer patients to have equivalent overall and stage-specific survival.”