Early mortality explains colorectal cancer survival gap between older, young patients

In patients with colorectal cancer (CRC), the survival gap between older and younger patient can largely be attributed to deaths during the first year after resection, a recent study has found.

Researchers retrieved population-based data from Belgium, Sweden, the Netherlands, and Norway, totaling 206,024 patients.

In general, survival during the first year was significantly worse in patients aged ≥75 years than comparators <65 years of age. This effect was most pronounced in Belgian patients, in whom the relative excess risk of death (RER) estimate from colon cancer was 2.5 (95 percent confidence interval [CI], 2.3–2.8) as compared with younger counterparts. A similar effect was reported for rectal cancer (RER, 2.6, 95 percent CI, 2.3–2.9).

Excess risks of death were slightly attenuated but nevertheless remained significant in patient from other countries, too.

Of note, beyond the first year, conditional relative survival was generally statistically comparable between older vs younger patients across all country cohorts.

“Although multimodality treatment, perioperative care, and consequently oncological outcome have improved in the past years, older patients with colorectal cancer still have a worse relative survival than their younger counterparts,” the researchers said.

“Together with a focus on early mortality, balancing under- and overtreatment, especially for stage III disease, is key to bridging the survival gap between younger and older patients with colorectal cancer that undergo surgical resection,” they added.