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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
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Treatment Delays in Early Age-Onset Colorectal Cancer.
Ryan T Heslin1, Zachary A Whitham1, Morgan F Pettigrew1
1Division of Surgical Oncology, Department of Surgery, UT Southwestern Medical Center, Dallas, Texas.
JAMA Oncology
|June 4, 2026
Summary
Early age-onset colorectal cancer (EOCRC) shows better survival, but treatment delays worsen outcomes. Addressing language barriers may improve timely care for EOCRC patients.
Area of Science:
- Oncology
- Public Health
- Epidemiology
Background:
- Incidence of early age-onset colorectal cancer (EOCRC) is rising.
- Treatment delays negatively impact colorectal cancer (CRC) outcomes.
- The specific effect of treatment delays on EOCRC requires further investigation.
Purpose of the Study:
- To assess the incidence of EOCRC.
- To identify patients experiencing treatment delays.
- To determine factors contributing to delayed therapy in EOCRC.
Main Methods:
- Retrospective, population-based cross-sectional study using the Texas Cancer Registry (2004-2019).
- Patients classified as EOCRC (age <50) or average age-onset colorectal cancer (AOCRC; age ≥50).
- Analysis of treatment delays (>6 weeks from diagnosis to therapy initiation) and overall survival (OS).
Main Results:
- 11% of 112,672 CRC patients had EOCRC.
- EOCRC patients were younger, less likely White, and more likely Hispanic than AOCRC patients.
- Treatment delays and higher Social Vulnerability Index were associated with worse OS in EOCRC. Language barriers were linked to treatment delays.
Conclusions:
- EOCRC is associated with improved OS compared to AOCRC.
- Treatment delays independently worsen survival in EOCRC patients.
- Language barriers represent a modifiable factor to improve timely EOCRC care and outcomes.
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