| Autor: |
Baronas VA; Division of Gastroenterology, University of British Columbia, Vancouver, BC V6T1Z4, Canada., Arif AA; Division of Gastroenterology, University of British Columbia, Vancouver, BC V6T1Z4, Canada., Bhang E; Division of Gastroenterology, University of British Columbia, Vancouver, BC V6T1Z4, Canada., Ladua GK; Division of Gastroenterology, University of British Columbia, Vancouver, BC V6T1Z4, Canada., Brown CJ; Division of Gastroenterology, University of British Columbia, Vancouver, BC V6T1Z4, Canada.; Department of Surgery, Division of General Surgery, St. Paul's Hospital, Vancouver, BC V6Z1Y6, Canada., Donnellan F; Division of Gastroenterology, University of British Columbia, Vancouver, BC V6T1Z4, Canada.; Division of Gastroenterology, Vancouver General Hospital, Vancouver, BC V5Z1M9, Canada., Gill S; Division of Gastroenterology, University of British Columbia, Vancouver, BC V6T1Z4, Canada.; BC Cancer, Vancouver, BC V6E1Y6, Canada., Stuart HC; Division of Gastroenterology, University of British Columbia, Vancouver, BC V6T1Z4, Canada.; BC Cancer, Vancouver, BC V6E1Y6, Canada., Loree JM; Division of Gastroenterology, University of British Columbia, Vancouver, BC V6T1Z4, Canada.; BC Cancer, Vancouver, BC V6E1Y6, Canada. |
| Abstrakt: |
Background : The incidence of colorectal cancer (CRC) is decreasing in individuals >50 years due to organised screening but has increased for younger individuals. We characterized symptoms and their timing before diagnosis in young individuals. Methods : We identified all patients diagnosed with CRC between 1990-2017 in British Columbia, Canada. Individuals <50 years ( n = 2544, EoCRC) and a matched cohort >50 ( n = 2570, LoCRC) underwent chart review to identify CRC related symptoms at diagnosis and determine time from symptom onset to diagnosis. Results: Across all stages of CRC, EoCRC presented with significantly more symptoms than LoCRC (Stage 1 mean ± SD: 1.3 ± 0.9 vs. 0.7 ± 0.9, p = 0.0008; Stage 4: 3.3 ± 1.5 vs. 2.3 ± 1.7, p < 0.0001). Greater symptom burden at diagnosis was associated with worse survival in both EoCRC ( p < 0.0001) and LoCRC ( p < 0.0001). When controlling for cancer stage, both age (HR 0.87, 95% CI 0.8-1.0, p = 0.008) and increasing symptom number were independently associated with worse survival in multivariate models. Conclusions : Patients with EoCRC present with a greater number of symptoms of longer duration than LoCRC; however, time from patient reported symptom onset was not associated with worse outcomes. |
