Time to Treatment for CRC Varies According to Patient Age

Adults younger than 50 years have longer times from colorectal cancer (CRC) presentation to diagnosis but shorter times from diagnosis to treatment start compared with adults 50 to 74 years, according to a population-based study published in the journal Gastroenterology.

“Our results suggest the small, significant effects in opposing directions for the diagnosis and treatment intervals by age result in similar overall times from presentation to treatment when younger adults are compared with middle-aged patients, after adjustment,” wrote corresponding author Nancy N. Baxter, MD, PhD, of the University of Melbourne in Australia, and study coauthors.

The study included 90,225 adults diagnosed with CRC in Ontario, Canada, between 2003 and 2018. Researchers grouped patients by age (younger than 50 years, between 50 and 74 years, and between 75 and 89 years) and compared times between presentation and diagnosis (diagnostic interval), diagnosis and treatment start (treatment interval), and presentation to treatment (overall interval). About 8% of patients in the study were younger than 50 years, who were more likely to be female, to present emergently, have stage IV disease, and have rectal cancer, than patients who were middle-aged.

Adjusted analyses found that adults younger than 50 years had significantly longer diagnostic intervals (4.3 days) and significantly shorter treatment intervals (−4.5 days) compared with patients 50 to 74 years. Nevertheless, the overall interval (−0.6 days) did not differ significantly between younger and middle-aged patients, the study found.

Overall intervals were longer in younger adults with stage IV disease who presented emergently and patients older than 75 years, according to the study.

“Young patients with stage IV disease experienced longer overall intervals than adults aged 50 to 74 years; however, the delay experienced was only an additional median 8.1 days,” researchers wrote.

Reference

Castelo M, Paszat L, Hansen BE, et al. Comparing time to diagnosis and treatment between younger and older adults with colorectal cancer: a population-based study. Gastroenterology. 2023;164(7):1152-1164. doi:10.1053/j.gastro.2023.02.024