Associations of advanced age with comorbidity, stage and primary subsite as contributors to mortality from colorectal cancer.
advanced age
cancer stage
colorectal cancer
comorbidity
mortality
Journal
Frontiers in public health
ISSN: 2296-2565
Titre abrégé: Front Public Health
Pays: Switzerland
ID NLM: 101616579
Informations de publication
Date de publication:
2023
2023
Historique:
received:
18
11
2022
accepted:
16
03
2023
medline:
25
4
2023
pubmed:
24
4
2023
entrez:
24
04
2023
Statut:
epublish
Résumé
Although survival from colorectal cancer (CRC) has improved substantially in recent decades, people with advanced age still have a high likelihood of mortality from this disease. Nonetheless, few studies have investigated how cancer stage, subsite and comorbidities contribute collectively to poor prognosis of older people with CRC. Here, we decided to explore the association of age with mortality measures and how other variables influenced this association. Using linkage of several administrative datasets, we investigated the risk of death among CRC cases during 2003-2014. Different models were used to explore the association of age with mortality measures and how other variables influenced this association. Our results indicated that people diagnosed at a young age and with lower comorbidity had a lower likelihood of all-cause and CRC-specific mortality. Aging had a greater association with mortality in early-stage CRC, and in rectal cancer, compared that seen with advanced-stage CRC and right colon cancer, respectively. Meanwhile, people with different levels of comorbidity were not significantly different in terms of their increased likelihood of mortality with advanced age. We also found that while most comorbidities were associated with all-cause mortality, only dementia [SHR = 1.43 (1.24-1.64)], Peptic ulcer disease [SHR = 1.12 (1.02-1.24)], kidney disease [SHR = 1.11 (1.04-1.20)] and liver disease [SHR = 1.65 (1.38-1.98)] were risk factors for CRC-specific mortality. This study showed that the positive association of advanced age with mortality in CRC depended on stage and subsite of the disease. We also found only a limited number of comorbidities to be associated with CRC-specific mortality. These novel findings implicate the need for more attention on factors that cause poor prognosis in older people.
Sections du résumé
Background
Although survival from colorectal cancer (CRC) has improved substantially in recent decades, people with advanced age still have a high likelihood of mortality from this disease. Nonetheless, few studies have investigated how cancer stage, subsite and comorbidities contribute collectively to poor prognosis of older people with CRC. Here, we decided to explore the association of age with mortality measures and how other variables influenced this association.
Methods
Using linkage of several administrative datasets, we investigated the risk of death among CRC cases during 2003-2014. Different models were used to explore the association of age with mortality measures and how other variables influenced this association.
Results
Our results indicated that people diagnosed at a young age and with lower comorbidity had a lower likelihood of all-cause and CRC-specific mortality. Aging had a greater association with mortality in early-stage CRC, and in rectal cancer, compared that seen with advanced-stage CRC and right colon cancer, respectively. Meanwhile, people with different levels of comorbidity were not significantly different in terms of their increased likelihood of mortality with advanced age. We also found that while most comorbidities were associated with all-cause mortality, only dementia [SHR = 1.43 (1.24-1.64)], Peptic ulcer disease [SHR = 1.12 (1.02-1.24)], kidney disease [SHR = 1.11 (1.04-1.20)] and liver disease [SHR = 1.65 (1.38-1.98)] were risk factors for CRC-specific mortality.
Conclusion
This study showed that the positive association of advanced age with mortality in CRC depended on stage and subsite of the disease. We also found only a limited number of comorbidities to be associated with CRC-specific mortality. These novel findings implicate the need for more attention on factors that cause poor prognosis in older people.
Identifiants
pubmed: 37089488
doi: 10.3389/fpubh.2023.1101771
pmc: PMC10116414
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1101771Informations de copyright
Copyright © 2023 Gheybi, Buckley, Vitry and Roder.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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