Clinical profile of early- and late-onset colorectal cancer patients in a referral medical center in Medellín, Colombia: A comparative analysis
DOI:
https://doi.org/10.30944/20117582.2576Palabras clave:
Neoplasias Colorrectales, Edad de Inicio, Epidemiología, Estudio Observacional, ColombiaResumen
Introduction. Incidence of early-onset colorectal cancer (EOCRC), defined as colorectal cancer (CRC) in individuals aged < 50 years, is rising worldwide. Despite the increasing international scientific production on EOCRC, research is limited in Colombia. The objective of this study was to characterize the clinical features of adults with EOCRC and late-onset CRC (LOCRC, CRC in individuals aged ≥ 50 years).
Methods. An observational, retrospective, cross-sectional study was conducted with CRC patients ≥ 18 years old at one medical center in Medellín, Colombia. Clinical and pathological data were retrieved from the Institutional Cancer Registry. Two analysis groups were established: EOCRC and LOCRC. The Chi2 test was applied to compare the variables of interest between both groups.
Results. The sample included 1,202 patients, 53.5% were female (N=643) and the median age was 65 years (interquartile range: 55-73). EOCRC represented 15.9% (N=192). LOCRC tended to have more history of cardiometabolic diseases and smoking than EOCRC (p<0.001). CRC family history was proportionally more frequent in EOCRC than in LOCRC (7.3% vs 3.8%; p=0.028). Right colon tumors were more common in LOCRC (30.4% vs 21.9%; p=0.041) and left colon tumors in EOCRC (30.7% vs 23.2%; p=0.041). Only one patient had inflammatory bowel disease history.
Conclusion. EOCRC is clinically distinct from LOCRC regarding pathological and toxicological history as well as tumor location. Our findings provide valuable insights for enhancing clinical decision-making, particularly in relation to age at onset in Colombian CRC patients.
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Referencias bibliográficas
Global Cancer Observatory: Cancer Today. International Agency for Research on Cancer. Published 2020. Accessed October 2, 2023. Available at: https://gco.iarc.fr/today/en
Sharma R, Abbasi-Kangevari M, Abd-Rabu R, Abidi H, Abu-Gharbieh E, Acuna JM, et al. Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol. 2022;7:627-47. https://doi.org/10.1016/S2468-1253(22)00044-9
Liu Y, Zhang C, Wang Q, Wu K, Sun Z, Tang Z, et al. Temporal Trends in the Disease Burden of Colorectal Cancer with Its Risk Factors at the Global and National Level from 1990 to 2019, and Projections Until 2044. Clin Epidemiol. 2023;15:55-71. https://doi.org/10.2147/CLEP.S388323
Situación del cáncer de la población atendida en el SGSSS en Colombia 2015. Published online 2015. Accessed October 2, 2023. Available at: https://cuentadealtocosto.org/
Situación del cáncer de la población atendida en el SGSSS en Colombia 2022. Published online 2022. Accessed October 2, 2023. Available at: https://cuentadealtocosto.org/
Bravo LE, Collazos T, Collazos P, García LS, Correa P. Trends of cancer incidence and mortality in Cali, Colombia. 50 years experience. Colomb Med (Cali). 2012;43:246-55.
Yépez MC, Jurado DM, Bravo LM, Bravo LE. Trends in cancer incidence, and mortality in Pasto, Colombia. 15 years experience. Colomb Med. 2018;49:42-54. https://doi.org/10.25100/cm.v49i1.3616
Uribe Pérez CJ, Serrano Gómez SE, Hormiga Sánchez CM. Cancer incidence and mortality in Bucaramanga, Colombia. 2008-2012. Colomb Med. 2018;49:73-80. https://doi.org/10.25100/cm.v49i1.3632
Vargas Moranth R, Navarro Lechuga E. Cancer incidence and mortality in Barranquilla, Colombia. 2008-2012. Colomb Med. 2018;49:55-62. https://doi.org/10.25100/cm.v49i1.3627
Hossain MS, Karuniawati H, Jairoun AA, Urbi Z, Ooi J, John A, et al. Colorectal cancer: A review of carcinogenesis, global epidemiology, current challenges, risk factors, preventive and treatment strategies. Cancers (Basel). 2022;14:1732. https://doi.org/10.3390/cancers14071732
Sinicrope FA. Increasing Incidence of Early-Onset Colorectal Cancer. N Engl J Med. 2022;386:1547-58. https://doi.org/10.1056/NEJMra2200869
Patel G, Patil P. Worrisome trends in young-onset colorectal cancer: Now is the time for action. Indian J Surg Oncol. 2022;13:446-52. https://doi.org/10.1007/s13193-022-01496-9
Dharwadkar P, Zaki TA, Murphy CC. Colorectal cancer in younger adults. Hematol Oncol Clin North Am. 2022;36:449-70. https://doi.org/10.1016/j.hoc.2022.02.005
Akimoto N, Ugai T, Zhong R, Hamada T, Fujiyoshi K, Giannakis M, et al. Rising incidence of early-onset colorectal cancer: a call for action. Nat Rev Clin Oncol. 2021;18:230-43. https://doi.org/10.1038/s41571-020-00445-1
Montenegro YM, Cuellar ATR, Muñetón CM, Isaza LF, Ramírez JL. Comportamiento del cáncer colorectal en pacientes menores de cuarenta años del Hospital Universitario Hernando Moncaleano Perdomo de Neiva (HUHMP) y el Hospital Universitario San Vicente de Paul de Medellín (HUSVP) entre 1980 y 2000. Rev Colomb Cir. 2002;17:10-14.
Cruz DF, Rojas A, Bastidas BE, Chamorro CMO. Cáncer del tubo digestivo en pacientes jóvenes del departamento del Cauca, tipificación clínica. Rev Colomb Cir. 2019;34:153-62. https://doi.org/10.30944/20117582.109
World Health Organization (WHO). International Classification of Diseases (ICD). 10th Ed. Published 2016. Accessed October 2, 2023. Available at: https://www.who.int/standards/classifications/classification-of-diseases
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344-9. https://doi.org/10.1016/j.jclinepi.2007.11.008
Edge S, Byrd D, Compton C, Fritz A, Greene F, Trotti A (eds). AJCC Cancer Staging Manual. 7th Ed. Springer; 2010.
Chatterjee A, Harris SB, Leiter LA, Fitchett DH, Teoh H, Bhattacharyya OK. Managing cardiometabolic risk in primary care: summary of the 2011 consensus statement. Can Fam Physician. 2012;58:389-93, e196-201.
Johnson CM, Wei C, Ensor JE, Smolenski DJ, Amos CI, Levin B, et al. Meta-analyses of colorectal cancer risk factors. CCC. 2013;24:1207-22. https://doi.org/10.1007/s10552-013-0201-5
Spaander MCW, Zauber AG, Syngal S, Blaser MJ, Sung JJ, You YN, et al. Young-onset colorectal cancer. Nat Rev Dis Primers. 2023;9:21. https://doi.org/10.1038/s41572-023-00432-7
Hua H, Jiang Q, Sun P, Xu X. Risk factors for early-onset colorectal cancer: systematic review and meta-analysis. Front Oncol. 2023;13:1132306. https://doi.org/10.3389/fonc.2023.1132306
REACCT Collaborative; Zaborowski AM, Abdile A, Adamina M, Aigner F, d’Allens L, et al. Characteristics of early-onset vs late-onset colorectal cancer: A review. JAMA Surg. 2021;156:865-74. https://doi.org/10.1001/jamasurg.2021.2380
Nfonsam V, Wusterbarth E, Gong A, Vij P. Early-onset colorectal cancer. Surg Oncol Clin N Am. 2022;31:143- 55. https://doi.org/10.1016/j.soc.2021.11.001
Bohorquez M, Sahasrabudhe R, Criollo A, Sanabria-Salas MC, Vélez A, Castro JM, et al. Clinical manifestations of colorectal cancer patients from a large multicenter study in Colombia. Medicine (Baltimore). 2016;95:e4883. https://doi.org/10.1097/MD.0000000000004883
Alvarez K, Cassana A, De La Fuente M, Canales T, Abedrapo M, López-Köstner F. Clinical, Pathological and molecular characteristics of Chilean patients with early-, intermediate- and late-onset colorectal cancer. Cells. 2021;10:631. https://doi.org/10.3390/cells10030631
Saraiva MR, Rosa I, Claro I. Early-onset colorectal cancer: A review of current knowledge. World J Gastroenterol. 2023;29:1289-303. https://doi.org/10.3748/wjg.v29.i8.1289
The Lancet Gastroenterology Hepatology. Addressing the rise of early-onset colorectal cancer. Lancet Gastroenterol Hepatol. 2022;7:197. https://doi.org/10.1016/S2468-1253(22)00003-6
Baran B, Mert Ozupek N, Yerli Tetik N, Acar E, Bekcioglu O, Baskin Y. Difference between left-sided and rightsided colorectal cancer: A focused review of literature. Gastroenterol Res. 2018;11:264-73. https://doi.org/10.14740/gr1062w
Stintzing S, Tejpar S, Gibbs P, Thiebach L, Lenz HJ. Understanding the role of primary tumour localisation in colorectal cancer treatment and outcomes. Eur J Cancer. 2017;84:69-80. https://doi.org/10.1016/j.ejca.2017.07.016
Willauer AN, Liu Y, Pereira AAL, Lam M, Morris JS, Raghav KPS, et al. Clinical and molecular characterization of early‐onset colorectal cancer. Cancer. 2019;125:2002- 10. https://doi.org/10.1002/cncr.31994
Lee GH, Malietzis G, Askari A, Bernardo D, Al-Hassi HO, Clark SK. Is right-sided colon cancer different to leftsided colorectal cancer? – A systematic review. Eur J Surg Oncol. 2015;41:300-8. https://doi.org/10.1016/j.ejso.2014.11.001
Strum WB, Boland CR. Clinical and genetic characteristics of colorectal cancer in persons under 50 years of age: A review. Dig Dis Sci. 2019;64:3059-65. https://doi.org/10.1007/s10620-019-05644-0
Muller C, Ihionkhan E, Stoffel EM, Kupfer SS. Disparities in early-onset colorectal cancer. Cells. 2021;10:1018. https://doi.org/10.3390/cells10051018
Nadeem MS, Kumar V, Al-Abbasi FA, Kamal MA, Anwar F. Risk of colorectal cancer in inflammatory bowel diseases. Semin Oncol. 2020;64:51-60. https://doi.org/10.1016/j.semcancer.2019.05.001
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