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Increasing age-related survival gap among patients with colorectal cancer: a population-based retrospective study

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Abstract

Background

Survival for patients with colorectal cancer (CRC) has improved over the past decades. However, it is unclear whether older patients have benefited to the same extent as younger patients.

Methods

The Surveillance, Epidemiology, and End Results (SEER) 9 registries database was queried for CRC patients from 1975 to 2009. We presented yearly data for survival with overlying loess-smoothing lines across all age groups. Another cohort was created using the SEER 18 registries database for patients diagnosed with CRC from 1973 to 2014. Yearly data for surgery-performed rate, stage proportion, and multivariate hazard ratio were performed with overlying smoothing lines across all age groups.

Results

In the analysis SEER 9, 5-year cause-specific survival (CSS) of patients aged ≤ 54, 55–64, and 65–74 years showed robust increase since 1975; however, the survival of patients aged 75–84 years remained low despite modest improvement, and patients aged 85 or older even showed no survival gains since 1990. In the analysis of SEER 18, there has been a steady increase in the survival of patients aged ≤ 54, 55–64, 65–74, and 75–84 years as time period advanced; however, of CRC patients aged ≥ 85 years, the survival curves of period 1990–1999 and 2000–2012 could not be distinguished from each other presented with negligibly a small gap from the curve of 1980–1989.

Conclusions

The strong interaction between age and year of diagnosis implies that older patients have benefited less over time than younger patients, especially for patients aged ≥ 85 years.

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Acknowledgements

The authors acknowledged the efforts of the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER database.

Funding

This study was supported by the National Key R&D Program of China (nos. 2016YFC0905300, 2016YFC0905301, and 2016YFC0905302), the Grant of Science and Technology Commission of Shanghai Municipality (no. 16401970502), the Grant of National Natural Science Foundation of China (no. 81572351), the Shanghai Shenkang Program (no. SHDC12014206), the National Science Foundation of China (no. 81702353) and Shanghai Municipal Natural Science Foundation (17ZR1406400). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Yang Feng, Shaobo Mo and Weixing Dai contributed equally to this work.

Authors and Affiliations

  1. Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, 270 Dong’an Road, Shanghai, 200032, China

    Yang Feng, Shaobo Mo, Weixing Dai, Qingguo Li, Guoxiang Cai & Sanjun Cai

  2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China

    Yang Feng, Shaobo Mo, Weixing Dai, Qingguo Li, Guoxiang Cai & Sanjun Cai

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  1. Yang Feng
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Correspondence to Qingguo Li, Guoxiang Cai or Sanjun Cai.

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Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of The Ethical Committee and Institutional Review Board of Fudan University Shanghai Cancer Center and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The Ethical Committee and Institutional Review Board of Fudan University Shanghai Cancer Center reviewed and approved this study protocol.

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Feng, Y., Mo, S., Dai, W. et al. Increasing age-related survival gap among patients with colorectal cancer: a population-based retrospective study. Int J Clin Oncol 25, 100–109 (2020). https://doi.org/10.1007/s10147-019-01538-3

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