Colorectal Cancer Resections in the Aging US Population: A Trend Toward Decreasing Rates and Improved Outcomes

Mehraneh D Jafari ¹, Fariba Jafari ¹, Wissam J Halabi ¹

⁰Department of Surgery, University of California, Irvine School of Medicine, Orange.

Jama Surgery +

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April 11, 2014

View abstract on PubMed

Summary

Colorectal cancer surgeries in older adults are increasing, with higher mortality and morbidity risks compared to younger patients. Despite overall mortality decreasing, elderly patients face greater in-hospital complications and costs.

Area Of Science

Oncology
Geriatric Surgery
Public Health

Background

Colorectal cancer (CRC) incidence is rising in the elderly.
Limited nationwide data exists on CRC resection outcomes in aging populations.
Surgical trends and outcomes for elderly CRC patients require examination.

Purpose Of The Study

To analyze surgical trends and outcomes of colorectal cancer treatment in the elderly population.
To compare in-hospital mortality and morbidity across different age groups undergoing CRC surgery.

Main Methods

A 10-year review (2001-2010) of the Nationwide Inpatient Sample database for CRC resections.
Patients stratified into age groups (45-64, 65-69, 70-74, 75-79, 80-84, 85+).
Multivariate logistic regression used to compare outcomes, controlling for confounders.

Main Results

Over 1 million CRC cases analyzed; 63.8% of surgeries were on patients 65+.
Patients 80+ had higher urgent admission rates and longer hospital stays.
Risk-adjusted mortality increased with age, with the 85+ group showing 4.72 times higher odds of in-hospital death compared to the 45-64 group.
Risk-adjusted morbidity also increased with age, with the 85+ group showing 1.96 times higher odds.

Conclusions

The majority of colorectal cancer surgeries are performed on older adults.
While overall mortality has decreased, elderly patients (65+) experience significantly higher risk-adjusted mortality and morbidity.
Further research and tailored care strategies are needed for elderly CRC patients.

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