Causes of death among early-onset colorectal cancer population in the United States: a large population-based study

Frontiers in Oncology

Oncology

Qihua Liang¹  Xiuhong Xu²  Lanping He³  Yuqun Tang⁴  Xiu Lu⁴  Guanshui Luo⁴  Yuerong Chen⁴  Chaosheng Wu⁴  Yuji Chen⁴ 

[1]Center of Digestive Endoscopology, The Second People’s Hospital of Luoding City, Luoding, China

[2]Department of Acupuncture and Massage Rehabilitation, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China

[3]Department of Gastroenterology, Fogang County People’s Hospital, Fogang, China

[4]Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China

关键词: early-onset colorectal cancer;    cause of death;    prognostic factor;    surveillance;    survivorship;   

DOI  :  10.3389/fonc.2023.1094493

 received in 2022-11-22, accepted in 2023-03-30,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundEarly-onset colorectal cancer (EOCRC) has an alarmingly increasing trend and arouses increasing attention. Causes of death in EOCRC population remain unclear.MethodsData of EOCRC patients (1975–2018) were extracted from the Surveillance, Epidemiology, and End Results database. Distribution of death was calculated, and death risk of each cause was compared with the general population by calculating standard mortality ratios (SMRs) at different follow-up time. Univariate and multivariate Cox regression models were utilized to identify independent prognostic factors for overall survival (OS).ResultsThe study included 36,013 patients, among whom 9,998 (27.7%) patients died of colorectal cancer (CRC) and 6,305 (17.5%) patients died of non-CRC causes. CRC death accounted for a high proportion of 74.8%–90.7% death cases within 10 years, while non-CRC death (especially cardiocerebrovascular disease death) was the major cause of death after 10 years. Non-cancer death had the highest SMR in EOCRC population within the first year after cancer diagnosis. Kidney disease [SMR = 2.10; 95% confidence interval (CI), 1.65–2.64] and infection (SMR = 1.92; 95% CI, 1.48–2.46) were two high-risk causes of death. Age at diagnosis, race, sex, year of diagnosis, grade, SEER stage, and surgery were independent prognostic factors for OS.ConclusionMost of EOCRC patients died of CRC within 10-year follow-up, while most of patients died of non-CRC causes after 10 years. Within the first year after cancer diagnosis, patients had high non-CRC death risk compared to the general population. Our findings help to guide risk monitoring and management for US EOCRC patients.

【 授权许可】

Unknown   
Copyright © 2023 Chen, He, Lu, Tang, Luo, Chen, Wu, Liang and Xu