Sex and age-related differences in one-, three-, and five-year survival for early-onset colorectal cancer in Georgia

We examined the relationships of sex and age specific groups with cause-specific survival for early-onset colorectal cancer (EOCRC) diagnosis. A retrospective cohort analysis utilizing data from the 2000-2020 Georgia Cancer Registry were performed. Sex and age at diagnosis were exposures of interest. CRC survival at 1-, 3, and 5-year intervals were our primary outcomes of interest. Traditional Cox proportional hazards regression and Piecewise Cox regression models were performed to examine the mentioned association. Among 11,935 EOCRC patients, males had lower 1- (89.4% vs. 91.9%), 3- (75.7% vs. 79.2%), and 5-year (69.7% vs. 74.3%) survival rates than female patients (all p-value <0.001). In adjusted analysis, regardless of survival intervals, male patients aged 30-39 years were more likely to die from CRC at 1-year (HR, 1.40; 95% CI, 1.08-1.82), 3-year (HR, 1.26; 95% CI, 1.06-1.49), 5-year (HR, 1.27; 95% CI, 1.09-1.48) than female aged 30-39 years, respectively. Our piecewise models also confirmed male patients aged 30-39 years were 33% more likely to die from CRC within 1 year interval. Similarly, male patients aged 40-49 years were more likely to die from CRC at 1-year (HR, 1.33; 95% CI, 1.16-1.53), 3-year (HR, 1.20; 95% CI, 1.10-1.32), and 5-year (HR, 1.22; 95% CI, 1.13-1.33) intervals than female patients aged 40-49 years, respectively. In summary, the highest estimate of EOCRC mortality within 1-year interval was observed among male patients aged 30-39 years. Prioritizing prevention and treatment strategies may reduce the risk of 1-year EOCRC mortality for males and 30-39 age group.