Colorectal cancer is the third leading cause of cancer death in the
United States, with an expected 134,490 new cases and 49,190 deaths in
2016. While incidence and mortality rates among adults 50 years and
older have decreased in the United States in recent years, the same
trend has not been observed for patients 20 to 49 years of age.
Treatment options for patients with young-onset colon cancer remain to
be defined and their effects on prognosis are unclear.
‘Young and middle-aged patients with colon cancer are nearly two to eight times more likely to receive postoperative chemotherapy than older patients, yet there is no added survival benefit for these patients.’
Young and middle-aged patients with colon cancer are nearly two to eight
times more likely to receive postoperative chemotherapy than older
patients, yet study results suggest no added survival benefit for these
patients, according to a study published online by JAMA Surgery
Kangmin Zhu of the John P. Murtha Cancer Center,
Walter Reed National Military Medical Center, Bethesda, Md., and
colleagues examined whether age differences in receiving chemotherapy
matched survival gains among patients diagnosed as having colon cancer
in an equal-access health care system.
The study was based on data from
the U.S. Department of Defense's Central Cancer Registry and Military
Heath System medical claims databases. There were 3,143 patients ages 18
to 75 years with histologically confirmed primary colon cancer
diagnosed between 1998 and 2007.
Of the patients, 59% were men. Young (18-49 years) and
middle-aged (50-64 years) patients were two to eight times more likely
to receive postoperative systemic chemotherapy compared with older
patients (65-75 years), regardless of tumor stage at diagnosis.
and middle-aged adults were 2.5 times more likely to receive multi-agent
chemotherapy regimens. While young and middle-aged adults who only
underwent surgery had better survival compared with older patients, no
significant differences in survival were seen between young/middle-aged
and older patients who received surgery plus postoperative systemic
"Most of the young patients received post-operative systemic
chemotherapy, including multi-agent regimens, which are currently not
recommended for most patients with early-stage colon cancer. Our
findings suggest over treatment of young and middle-aged adults with
colon cancer," the authors write.