Maria S Altieri1, Hannah Thompson2, Aurora Pryor2, Jie Yang3, Chencan Zhu4, Mark Talamini2, Jill Genua2. 1. Division of General and Bariatric Surgery, Department of Surgery, East Carolina University Brody School of Medicine, 600 Moye Boulevard, Greenville, NC, 27834, USA. Altieri.m@gmail.com. 2. Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA. 3. Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA. 4. Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA.
Abstract
INTRODUCTION: The American Cancer Society recently lowered the recommended age for screening of colorectal cancer (CRC) to age 45 due to recent data showing increased incidence of CRC in younger populations. The purpose of this study was to evaluate if younger patients have increased likelihood of resection for CRC through the use of a statewide longitudinal database. METHODS: The New York SPARCS administrative database was used to identify all patients with diagnosis of colon cancer undergoing colorectal resections from 2000 to 2016. Patients were divided into seven age groups. Patients' characteristics, demographics, co-morbidities, and complications were evaluated. Chi-square test was used to compare patients' characteristics, comorbidities and complications among age groups. The linear trend of colon resection in different age groups over years was examined using log-linear Poisson regression models with year as an explanatory variable, as well as using multivariable logistic regression models after adjusting for patients' gender, race, payment, region, any comorbidity and any complication. RESULTS: There were 73,697 colon resection surgeries extracted from 2000 to 2016. Younger age was significantly associated with increased colorectal cancer resection over time. Patients age 21-70 had a significantly increasing trend over the years (age group 21-30: RR 1.06, p-value < 0.0001; age group 31-40: RR 1.04, p < 0.0001; age group 41-50: RR 1.04, p < 0.0001; age group 51-60: RR 1.02. p < 0.0001); age group 61-70: RR 1.01, p = 0.0012). Patient age > 70 was significantly associated with decreasing trend of colorectal cancer resection over the years (age group 71-80: RR 0.98, p < 0.0001 and age group > 80: RR 0.99, p-value < 0.0001). Such trends also existed after further adjustment for patients' characteristics, any comorbidity and any complication. CONCLUSION: Over the years, younger patients have an increased trend of undergoing colorectal resections for cancer, with up to a 6% yearly increase over the studied period. New screening initiation guidelines should be considered and awareness among clinicians and the general public should be increased.
INTRODUCTION: The American Cancer Society recently lowered the recommended age for screening of colorectal cancer (CRC) to age 45 due to recent data showing increased incidence of CRC in younger populations. The purpose of this study was to evaluate if younger patients have increased likelihood of resection for CRC through the use of a statewide longitudinal database. METHODS: The New York SPARCS administrative database was used to identify all patients with diagnosis of colon cancer undergoing colorectal resections from 2000 to 2016. Patients were divided into seven age groups. Patients' characteristics, demographics, co-morbidities, and complications were evaluated. Chi-square test was used to compare patients' characteristics, comorbidities and complications among age groups. The linear trend of colon resection in different age groups over years was examined using log-linear Poisson regression models with year as an explanatory variable, as well as using multivariable logistic regression models after adjusting for patients' gender, race, payment, region, any comorbidity and any complication. RESULTS: There were 73,697 colon resection surgeries extracted from 2000 to 2016. Younger age was significantly associated with increased colorectal cancer resection over time. Patients age 21-70 had a significantly increasing trend over the years (age group 21-30: RR 1.06, p-value < 0.0001; age group 31-40: RR 1.04, p < 0.0001; age group 41-50: RR 1.04, p < 0.0001; age group 51-60: RR 1.02. p < 0.0001); age group 61-70: RR 1.01, p = 0.0012). Patient age > 70 was significantly associated with decreasing trend of colorectal cancer resection over the years (age group 71-80: RR 0.98, p < 0.0001 and age group > 80: RR 0.99, p-value < 0.0001). Such trends also existed after further adjustment for patients' characteristics, any comorbidity and any complication. CONCLUSION: Over the years, younger patients have an increased trend of undergoing colorectal resections for cancer, with up to a 6% yearly increase over the studied period. New screening initiation guidelines should be considered and awareness among clinicians and the general public should be increased.
Authors: Jessica B O'Connell; Melinda A Maggard; Jerome H Liu; David A Etzioni; Edward H Livingston; Clifford Y Ko Journal: Am Surg Date: 2003-10 Impact factor: 0.688