Red-flag signs and symptoms for earlier diagnosis of early-onset colorectal cancer.

Autor:	Fritz CDL; Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA., Otegbeye EE; Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA., Zong X; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA., Demb J; Division of Gastroenterology, University of California San Diego, San Diego, CA, USA.; Moores Cancer Center, University of California San Diego, La Jolla, CA, USA., Nickel KB; Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA., Olsen MA; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.; Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA., Mutch M; Section of Colon and Rectal Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA., Davidson NO; Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA., Gupta S; Division of Gastroenterology, University of California San Diego, San Diego, CA, USA.; Moores Cancer Center, University of California San Diego, La Jolla, CA, USA.; Department of Internal Medicine, University of California San Diego, San Diego, CA, USA.; Veteran Affairs San Diego Healthcare System, Department of Medicine, Division of Gastroenterology, San Diego, CA, USA., Cao Y; Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.; Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
Jazyk:	angličtina
Zdroj:	Journal of the National Cancer Institute [J Natl Cancer Inst] 2023 Aug 08; Vol. 115 (8), pp. 909-916.
DOI:	10.1093/jnci/djad068
Abstrakt:	Background: Prompt detection of colorectal cancer (CRC) among individuals younger than age 50 years (early-onset CRC) is a clinical priority because of its alarming rise. Methods: We conducted a matched case-control study of 5075 incident early-onset CRC among US commercial insurance beneficiaries (113 million adults aged 18-64 years) with 2 or more years of continuous enrollment (2006-2015) to identify red-flag signs and symptoms between 3 months to 2 years before the index date among 17 prespecified signs and symptoms. We assessed diagnostic intervals according to the presence of these signs and symptoms before and within 3 months of diagnosis. Results: Between 3 months and 2 years before the index date, 4 red-flag signs and symptoms (abdominal pain, rectal bleeding, diarrhea, and iron deficiency anemia) were associated with an increased risk of early-onset CRC, with odds ratios (ORs) ranging from 1.34 to 5.13. Having 1, 2, or at least 3 of these signs and symptoms were associated with a 1.94-fold (95% confidence interval [CI] = 1.76 to 2.14), 3.59-fold (95% CI = 2.89 to 4.44), and 6.52-fold (95% CI = 3.78 to 11.23) risk (Ptrend < .001), respectively, with stronger associations for younger ages (Pinteraction < .001) and rectal cancer (Pheterogenity = .012). The number of different signs and symptoms was predictive of early-onset CRC beginning 18 months before diagnosis. Approximately 19.3% of patients had their first sign or symptom occur between 3 months and 2 years before diagnosis (median diagnostic interval = 8.7 months), and approximately 49.3% had the first sign or symptom within 3 months of diagnosis (median diagnostic interval = 0.53 month). Conclusions: Early recognition of red-flag signs and symptoms (abdominal pain, rectal bleeding, diarrhea, and iron-deficiency anemia) may improve early detection and timely diagnosis of early-onset CRC. (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu