Related Experiment Video
Updated: Aug 8, 2026
06:46
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Surgery Utilization Mediates Survival in Patients With Dementia and Stage I-III Colorectal Cancer
Evan M Abbey1, Vashisht V Madabhushi1, Meghan E Lark1
1Surgical Outcomes and Quality Improvement Center, Indiana University, Indianapolis, Indiana, USA.
Journal of the American Geriatrics Society
|August 7, 2026
Summary
Patients with colorectal cancer (CRC) and dementia have lower survival rates, partly due to reduced surgery rates. Discussing patient-centered goals of care is crucial for treatment planning in this population.
Area of Science:
- Oncology
- Geriatrics
- Public Health
Background:
- Dementia is linked to poorer outcomes and less aggressive treatment in colorectal cancer (CRC) patients.
- Understanding treatment disparities and survival differences in CRC patients with dementia is critical.
Purpose of the Study:
- To compare demographics and treatment patterns in CRC patients with and without dementia.
- To evaluate the impact of dementia on surgery receipt and overall survival.
Main Methods:
- Utilized Indiana Cancer Registry data (2000-2020) for Stage I-III CRC patients.
- Identified dementia using ICD-9/10 codes; survival analyzed via Kaplan-Meier and log-rank tests.
- Employed causal mediation analysis to assess surgery's role in the dementia-survival relationship.
Main Results:
- 1516 (2.1%) of 69,318 CRC patients had dementia; they were older and more likely female.
- Patients without dementia exhibited significantly higher survival probabilities at all time points.
- Surgery receipt significantly mediated survival differences in dementia patients, accounting for 9.6% of the effect.
Conclusions:
- CRC patients with dementia receive surgery less often, with higher refusal rates.
- Disparities in surgical utilization significantly mediate survival differences.
- Emphasizes the need for patient-centered discussions regarding surgical benefits and burdens.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
01:21Cancer Survival Analysis
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...