Do treatment patterns differ in those with early-onset colorectal cancer?

Area of Science:

• Oncology
• Gastroenterology
• Clinical Research

Background:

• Rising incidence of early-onset colorectal cancer (EOCRC).
• International guidelines recommend consistent treatment for EOCRC and late-onset colorectal cancer (LOCRC).
• Previous studies indicate more aggressive treatment for EOCRC without survival benefits.

Purpose of the Study:

• To compare treatment patterns for stages 2 and 3 EOCRC versus LOCRC.
• To investigate potential disparities in care for younger colorectal cancer patients.

Main Methods:

• Retrospective, population-based cohort study.
• Analysis of colorectal cancer patients diagnosed in Canterbury, New Zealand (2010-2021).
• Comparison of treatment between EOCRC (<50 years) and LOCRC (60-74 years) cohorts.

Main Results:

• EOCRC patients (stage 2) were more likely to receive adjuvant chemotherapy (p<0.001).
• EOCRC patients (stages 2-3) were more likely to receive multi-agent therapy (p<0.01).
• Increased treatment intensity in EOCRC did not correlate with improved survival.

Conclusions:

• EOCRC patients receive more intensive treatment, particularly adjuvant chemotherapy, without survival advantage.
• Potential for increased treatment-related harms exists, especially in stage 2 EOCRC.
• Clinicians must consider treatment biases and harms when managing young colorectal cancer patients.