Proximal shift of colorectal cancer with increasing age in different ethnicities
Received 25 February 2018
Accepted for publication 6 June 2018
Published 15 August 2018 Volume 2018:10 Pages 2663—2673
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Antonella D'Anneo
Lin Yang,1–3 Zhenchong Xiong,1–3 Wenzhuo He,1–3 Kunqian Xie,1–3 Shousheng Liu,1–3 Pengfei Kong,1–3 Chang Jiang,1–3 Guifang Guo,1–3,* Liangping Xia1–3,*
1Department of VIP, Sun Yat-sen University Cancer Center, Guangzhou, China; 2State Key Laboratory of Oncology in Southern China, Guangzhou, China; 3Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
*These authors contributed equally to this work
Background: Studies have indicated a variation in colon cancer pathology with increased age. More findings have also suggested differences in genetics, biology, and demography in terms of ethnicity. Large-scale studies closely examining tumor location shift with aging and ethnicity are scarce.
Objective: We compared the tumor location shift with aging and the difference in survival based on tumor location by age group among the African-American, White, and Asian/Pacific Islander patients with colorectal cancer.
Materials and methods: We collected 270,390 cases from the Surveillance, Epidemiology, and End Results database between 2004 and 2014. Ethnicity distribution between younger (age <70 years) and older (age ≥70 years) patients was analyzed using univariate and multivariate logistic regression. The Kaplan–Meier method was used to compare the tumor location survival difference in the African-American, White, and Asian/Pacific Islander patients.
Results: Larger tumors, female sex, M0, advanced N stage, no treatment, moderate to poor differentiation, total number of lymph nodes evaluated >12, and right-sided colon cancer were more common in patients aged ≥70 years. More adverse prognosis was found in younger patients compared to older patients. Tumor location frequency differed based on age; the most pronounced differences were found in White patients. The right-sided colon cancer survival inferiority was present only in White patients.
Conclusion: Our findings support the premise of etiological and carcinogenic differences based on tumor location and between younger and older patients.
Keywords: age, proximal shift, tumor location, ethnicity, SEER, colorectal cancer
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