How Metastatic Colorectal Cancer Impacts Population Health

Although young patients with metastatic colorectal cancer tend to be more fit and receive more intensive treatment than older patients, both groups have roughly the same survival rate. That is the main takeaway from a recent study by the Dana-Farber Cancer Institute examining population health.

These findings come as colorectal cancer rates are on the rising among younger populations. However, the researchers indicated the results were somewhat surprising. Younger patients tend to have fewer complicating health factors and are often expected to survive longer than older patients.

“As a group, younger patients are more physically active and have higher performance status and are better able to perform the activities of daily living than older patients. They also tend to be treated with higher doses of therapy and have less severe side effects,” said study senior author and director of the Young-Onset Colorectal Cancer Center at Dana-Farber, Kimmie Ng, MD, MPH, said in a press release.

“This is the first study to compare survival in younger versus older patients participating in a clinical trial of treatment for metastatic colorectal cancer.”

The study examined data from the CALGB/SWOG 80405 clinical trial, which tested a combination of chemotherapy and biologic therapy in patients with metastatic colorectal cancer. The team then compared the survival times in 514 trial participants who were younger than age 50 with the survival times of 1,812 patients above 50.

According to Dana-Farber’s Marla Lipsyc-Sharf, MD, there were no significant differences in the survival rates between the two populations.

“The median survival for patients with young-onset colorectal cancer was 27.07 months vs. 26.12 months for the older-onset group. Progression-free survival – how long patients lived before the cancer worsened — was also similar for the two groups: 10.87 months for the younger patients vs. 10.55 for the older ones,” the press release stated.

Additionally, researchers found that patients under age 35 had the shortest median overall survival time of any group at 21.95 months and 26.12 months in older-onset patients. While the study used a relatively small population of patients under age 35, researchers said the results align with previous findings suggesting that very young populations have worse health outcomes.

According to researchers, the results underscore that there is still much to learn about young-onset colorectal cancer as cases increase. For example, between 2000 and 2013, the incidence of the disease in people under the age of 50 increased by about 22 percent.

“If current trends hold, colorectal cancer is projected to be the second leading cancer and leading cause of cancer death in patients ages 20-49 by the year 2040,” Lipsyc-Sharf stated. “It is important to understand survival in this population in order to develop tailored treatments.”

Researchers can advance precision medicine treatments to improve patient outcomes by understanding how the disease develops in younger populations.