Demographics Predict Stage III/IV Colorectal Cancer in Individuals Under Age 50.

Area of Science:

• Oncology
• Epidemiology
• Public Health

Background:

• Colorectal cancer (CRC) incidence is rising in individuals under 50 (early-onset CRC).
• Over 60% of early-onset CRC patients are diagnosed with advanced disease (stage III/IV).
• Predictors of advanced stage in this demographic are not well-defined.

Purpose of the Study:

• To quantify the association between demographic factors and advanced colorectal cancer (CRC) in patients under age 50.
• To identify predictors of advanced stage at diagnosis for early-onset CRC.

Main Methods:

• Analysis of 37,044 CRC cases diagnosed between ages 20-49 in the US SEER 18 database (2004-2015).
• Logistic regression models used to assess the impact of age, sex, race, ethnicity, marital status, and cancer site on advanced disease probability.

Main Results:

• Younger age was inversely associated with advanced disease; 20-24-year-olds had 53% greater odds than 45-49-year-olds.
• Asian, black, and Pacific Islander individuals had higher odds of advanced CRC compared to whites (10-45% greater odds).
• Non-partnered individuals had 11% higher odds of advanced CRC; colon cancer was more likely to be diagnosed at stage IV than rectal cancer.

Conclusions:

• Younger age, Asian, black, or Pacific Islander race, and being non-partnered predict advanced early-onset CRC.
• Colon cancer is more frequently diagnosed at stage IV compared to rectal cancer.
• Demographic factors associated with advanced CRC may reflect tumor biology differences and healthcare access disparities.