Timely diagnosis improves survival in older patients with advanced colon cancer

Timely diagnosis of colon cancer could help improve the poor survival rates in older patients, a recent study has found.

The study included 21,270 older colon cancer patients (median age at diagnosis 74 years, 51.7 percent women) diagnosed between 1 January 2006 and 31 July 2017, and followed until the end of 2019. Regional cancer was predominant (43.2 percent), while 24.0 percent and 21.3 percent had local cancers and distant metastasis, respectively.

The 1- and 3-year net survival estimates were 98.1 percent and 95.8 percent in patients with localized disease, 91.4 percent and 79.8 percent in those with regional cancers, and 38.3 percent and 15.9 percent in patients with distant metastasis, respectively.

Notably, net survival rates decreased with increasing age, though the disadvantage in the older age subgroups was more apparent for more advanced tumours. In particular, the excess mortality hazard (EMH) was low for all ages in the subgroup of patients with localized colon cancer. In contrast, the EMH was obvious for older patients with regional and distant diseases, particularly during the first 6 and 18 months after diagnosis, respectively.

Such excess hazard was affected by delays in diagnosis. For example, patients with distant metastasis who were not diagnosed with colorectal cancer after emergency presentation had higher EMH during the first 6 months.

“It is utopian to believe that colon cancer survival in older patients may equal that in middle-aged patients,” the researchers said. “However, there are opportunities for enhancement, notably in improving earlier diagnosis in older adults. Efforts towards this goal are likely to help reduce age disparities in colon cancer survival.”