Clinical and pathological differences between early- and late-onset colorectal cancer and determinants of one-year all-cause mortality among advanced-stage patients: a retrospective cohort study in Medellín, Colombia

Álvaro Esteban Ruiz-Grajales; Manuela María Orozco-Puerta; Senshuang Zheng; Geertruida H de Bock; Juan Camilo Correa-Cote; Esteban Castrillón-Martínez

doi:10.1016/j.ctarc.2024.100797

Clinical and pathological differences between early- and late-onset colorectal cancer and determinants of one-year all-cause mortality among advanced-stage patients: a retrospective cohort study in Medellín, Colombia

Cancer Treat Res Commun. 2024 Feb 15:39:100797. doi: 10.1016/j.ctarc.2024.100797. Online ahead of print.

Authors

Álvaro Esteban Ruiz-Grajales¹, Manuela María Orozco-Puerta², Senshuang Zheng³, Geertruida H de Bock⁴, Juan Camilo Correa-Cote⁵, Esteban Castrillón-Martínez⁶

Affiliations

¹ Semillero de Investigación en Salud (SEIS), Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia. Electronic address: aesteban.ruiz@udea.edu.co.
² Semillero de Investigación en Salud (SEIS), Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia. Electronic address: manuela.orozcop@udea.edu.co.
³ Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: s.zheng02@umcg.nl.
⁴ Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: g.h.de.bock@umcg.nl.
⁵ Clínica Medellín, Medellín, Colombia. Electronic address: jcamilo.correa@udea.edu.co.
⁶ Semillero de Investigación en Salud (SEIS), Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia; Hospital Alma Máter de Antioquia, Medellín, Colombia. Electronic address: esteban.castrillonm@almamater.hospital.

PMID: 38367413
DOI: 10.1016/j.ctarc.2024.100797

Abstract

Objective: To identify the differences between early- (EOCRC) and late-onset colorectal cancer (LOCRC), and to evaluate the determinants of one-year all-cause mortality among advanced-stage patients.

Methods: A retrospective cohort study was carried out. CRC patients ≥ 18 years old were included. Chi-Square test was applied to compare both groups. Uni- and multivariate regressions were performed to evaluate the determinants of one-year all-cause mortality in all advanced-stage patients regardless of age of onset.

Results: A total of 416 patients were enrolled; 53.1 % were female. Ninety cases (21.6 %) had EOCRC and 326 (78.4 %) had LOCRC. EOCRC cases were predominantly sporadic (88.9 %). Histology of carcinoma other than adenocarcinoma (p= 0.044) and rectum tumors (p= 0.039) were more prevalent in EOCRC. LOCRC patients were more likely to have smoking history (p < 0.001) and right colon tumors (p = 0.039). Alcohol consumption history (odds ratio [OR]: 3.375, 95 %CI: 1.022-11.150) and stage IV (OR: 12.632, 95 %CI: 3.506-45.513) were associated with higher one-year all-cause mortality among advanced-stage patients, the opposite was noted with left colon tumors (OR: 0.045, 95 %CI: 0.003-0.588).

Conclusion: EOCRC was predominantly sporadic and had more cases of uncommon histological subtypes and rectal tumors. LOCRC was characterized by a higher prevalence of smoking history. Multivariate regression revealed an association between higher one-year all-cause mortality and alcohol consumption history and stage IV in advanced-stage patients. CRC exhibited differences based on age of onset. The evaluated factors associated with CRC mortality provide valuable insights for healthcare professionals, emphasizing the importance of adequate clinical assessment and early CRC diagnosis.

Keywords: Age of onset; Colombia; Colorectal neoplasms; Epidemiology; Mortality; Neoplasm staging.