Colorectal cancer in patients younger than 40 is more likely to grow despite treatment and young patients are at greater risk of death than people in other age groups. Christopher Lieu, MD, CU Cancer Center investigator
That’s according to research presented to the 2013 European Cancer Congress in Amsterdam. The team of scientists is led by an investigator at University of Colorado Cancer Center.
An analysis of 20,034 patients in 24 phase III clinical trials showed that the youngest and oldest patients had the highest risk of disease progression and death, compared to middle-aged patients. When compared to 57 year-olds, people under 40 had a 30% increased risk of dying from the disease, and, when compared to 61-year-olds, they had a 28% increased risk of their disease spreading during the first year of follow-up.
Colorectal cancer occurs in 4.6% of patients who are younger than 50, the incidence of the disease has been increasing at a rate of 1.5% per year from 1992 to 2005 in this age group. The most dramatic increases have been observed in the 20-29 year-old group, with an annual 5.2% increase in cases in men and a 5.6% increase in women. In the 30-39 year-old group, there has been an annual 3% increase in men and a 2% increase in women.
“The reasons why the incidence of colorectal cancer is increasing in younger patients remain unknown, although genetic predisposition, environmental factors, fewer early cancer detections in this population or a combination of these factors are thought to play a role,” said Christopher Lieu, MD, a CU Cancer Center investigator and assistant professor at CU’s School of Medicine.
“We carried out this study to see whether age was associated with time until cancer progresses or the patient dies. We also wanted to get a better picture of the ageresponse relationship and identify how risk changes as people age, rather than simply comparing one group (patients younger than 40) with another group (patients older than 40),” Lieu said.
Previous studies in this field have split the population into two mutually exclusive groups, establishing rigid limits between those patients younger than 40 or 50 and those older than that age. The new research, however, did not use such a cut-off approach and includes data spanning all ages.
“The reason we did this is we believe a 49-year-old patient with colorectal cancer may be different than a 20-year-old. By including them in the same group of people younger than 50 years old, we might be mistakenly considering them the same,” said Lieu.
Lieu and his colleagues analyzed information from a database of clinical trials in advanced colorectal cancer supported by the French “Aide et Recherche en Cancérologie Digestive” Foundation (ARCAD), which includes the 20,034 patients from 24 phase III clinical trials who were on their first treatment for the disease. There was additional patient data in which patients might be on second or third line treatment, having not responded to their initial therapy. Out of these patients, 20,011 were evaluable for analysis of survival time and time until the disease progressed.
“Analysis of this incredibly large population of patients has allowed us to answer meaningful questions, such as the outcomes of young versus older patients. Our results show young age is associated with worse overall survival and progression-free survival,” said Lieu. “Young patients with metastatic colorectal cancer represent a group who are at high risk for treatment failure.”
Despite the comprehensive nature of the study, more research will be required to identify why colorectal cancer in younger people appears to be more aggressive. Lieu and collaborators from University of Texas MD Anderson Cancer Center are now looking at the biological differences that may account for the higher risk of death in people under the age of 40.
Erika Matich | EurekAlert!
The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig
Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)
The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.
Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...
Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.
That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...
Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.
During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....
The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.
Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...
Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...
15.11.2017 | Event News
15.11.2017 | Event News
30.10.2017 | Event News
20.11.2017 | Life Sciences
20.11.2017 | Materials Sciences
20.11.2017 | Life Sciences