Clinicopathologic and Racial/Ethnic Differences of Colorectal Cancer Among Adolescents and Young Adults

Andreana N. Holowatyj, Mark A. Lewis, Samantha T. Pannier, Anne C. Kirchhoff, Sheetal Hardikar, Jane C. Figueiredo, Lyen C. Huang, David Shibata, Stephanie L. Schmit, Cornelia M. Ulrich

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Despite overall reductions in colorectal cancer burden, incidence rates continue to rise among younger patients, and causes remain unknown. We examined differences in clinicopathologic and racial/ethnic characteristics within the adolescent and young adult (AYA) population diagnosed with colorectal cancer in the United States. METHODS: Using the National Cancer Institute's Surveillance, Epidemiology, and End Results program data, we identified individuals diagnosed with first primary colorectal cancer between ages 15 and 39 years from 2010 to 2015. Adjusted multivariable logistic regression models were used to quantify clinicopathologic and racial/ethnic differences across age at onset subgroups (15-19, 20-24, 25-29, 30-34, and 35-39 years). RESULTS: We identified 5,350 AYA patients diagnosed with colorectal cancer. Of note, 28.6% of AYA cases were diagnosed with right-sided tumors (cecum to transverse colon). The proportion of right-sided colorectal cancers differed significantly by age group at diagnosis (38.3% vs 27.3% of AYAs aged 15-19 vs 35-39 years, respectively; P trend = 0.01). Proportions of cases with mucinous adenocarcinoma and signet ring cell carcinoma histopathologic subtypes significantly increased with younger age at onset (P trends = 0.01 and 0.03, respectively). Differences in clinical stage were observed across AYA age groups, with stage II disease increasing with younger age (P trend = 0.01). The proportion of Hispanic AYAs was higher within younger patients, accounting for 21.0% of the AYA population aged 35-39 years up to 28.3% of 15-19-year-old individuals (P trend = 0.003). DISCUSSION: Within the AYA population, colorectal cancers differ by clinicopathologic and racial/ethnic characteristics. Further investigation of the clinical and biologic diversity of colorectal cancers that partially underlie age- and race-related differences in cancer susceptibility and outcomes is warranted.

Original languageEnglish (US)
Pages (from-to)e00059
JournalClinical and translational gastroenterology
Volume10
Issue number7
DOIs
StatePublished - Jul 1 2019

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Young Adult
Colorectal Neoplasms
Age of Onset
Age Groups
Logistic Models
Signet Ring Cell Carcinoma
SEER Program
Population
Mucinous Adenocarcinoma
Transverse Colon
National Cancer Institute (U.S.)
Cecum
Hispanic Americans
Neoplasms
Incidence

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Holowatyj, A. N., Lewis, M. A., Pannier, S. T., Kirchhoff, A. C., Hardikar, S., Figueiredo, J. C., ... Ulrich, C. M. (2019). Clinicopathologic and Racial/Ethnic Differences of Colorectal Cancer Among Adolescents and Young Adults. Clinical and translational gastroenterology, 10(7), e00059. https://doi.org/10.14309/ctg.0000000000000059

Clinicopathologic and Racial/Ethnic Differences of Colorectal Cancer Among Adolescents and Young Adults. / Holowatyj, Andreana N.; Lewis, Mark A.; Pannier, Samantha T.; Kirchhoff, Anne C.; Hardikar, Sheetal; Figueiredo, Jane C.; Huang, Lyen C.; Shibata, David; Schmit, Stephanie L.; Ulrich, Cornelia M.

In: Clinical and translational gastroenterology, Vol. 10, No. 7, 01.07.2019, p. e00059.

Research output: Contribution to journalArticle

Holowatyj, AN, Lewis, MA, Pannier, ST, Kirchhoff, AC, Hardikar, S, Figueiredo, JC, Huang, LC, Shibata, D, Schmit, SL & Ulrich, CM 2019, 'Clinicopathologic and Racial/Ethnic Differences of Colorectal Cancer Among Adolescents and Young Adults', Clinical and translational gastroenterology, vol. 10, no. 7, pp. e00059. https://doi.org/10.14309/ctg.0000000000000059
Holowatyj, Andreana N. ; Lewis, Mark A. ; Pannier, Samantha T. ; Kirchhoff, Anne C. ; Hardikar, Sheetal ; Figueiredo, Jane C. ; Huang, Lyen C. ; Shibata, David ; Schmit, Stephanie L. ; Ulrich, Cornelia M. / Clinicopathologic and Racial/Ethnic Differences of Colorectal Cancer Among Adolescents and Young Adults. In: Clinical and translational gastroenterology. 2019 ; Vol. 10, No. 7. pp. e00059.
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abstract = "OBJECTIVES: Despite overall reductions in colorectal cancer burden, incidence rates continue to rise among younger patients, and causes remain unknown. We examined differences in clinicopathologic and racial/ethnic characteristics within the adolescent and young adult (AYA) population diagnosed with colorectal cancer in the United States. METHODS: Using the National Cancer Institute's Surveillance, Epidemiology, and End Results program data, we identified individuals diagnosed with first primary colorectal cancer between ages 15 and 39 years from 2010 to 2015. Adjusted multivariable logistic regression models were used to quantify clinicopathologic and racial/ethnic differences across age at onset subgroups (15-19, 20-24, 25-29, 30-34, and 35-39 years). RESULTS: We identified 5,350 AYA patients diagnosed with colorectal cancer. Of note, 28.6{\%} of AYA cases were diagnosed with right-sided tumors (cecum to transverse colon). The proportion of right-sided colorectal cancers differed significantly by age group at diagnosis (38.3{\%} vs 27.3{\%} of AYAs aged 15-19 vs 35-39 years, respectively; P trend = 0.01). Proportions of cases with mucinous adenocarcinoma and signet ring cell carcinoma histopathologic subtypes significantly increased with younger age at onset (P trends = 0.01 and 0.03, respectively). Differences in clinical stage were observed across AYA age groups, with stage II disease increasing with younger age (P trend = 0.01). The proportion of Hispanic AYAs was higher within younger patients, accounting for 21.0{\%} of the AYA population aged 35-39 years up to 28.3{\%} of 15-19-year-old individuals (P trend = 0.003). DISCUSSION: Within the AYA population, colorectal cancers differ by clinicopathologic and racial/ethnic characteristics. Further investigation of the clinical and biologic diversity of colorectal cancers that partially underlie age- and race-related differences in cancer susceptibility and outcomes is warranted.",
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AU - Holowatyj, Andreana N.

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AU - Pannier, Samantha T.

AU - Kirchhoff, Anne C.

AU - Hardikar, Sheetal

AU - Figueiredo, Jane C.

AU - Huang, Lyen C.

AU - Shibata, David

AU - Schmit, Stephanie L.

AU - Ulrich, Cornelia M.

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N2 - OBJECTIVES: Despite overall reductions in colorectal cancer burden, incidence rates continue to rise among younger patients, and causes remain unknown. We examined differences in clinicopathologic and racial/ethnic characteristics within the adolescent and young adult (AYA) population diagnosed with colorectal cancer in the United States. METHODS: Using the National Cancer Institute's Surveillance, Epidemiology, and End Results program data, we identified individuals diagnosed with first primary colorectal cancer between ages 15 and 39 years from 2010 to 2015. Adjusted multivariable logistic regression models were used to quantify clinicopathologic and racial/ethnic differences across age at onset subgroups (15-19, 20-24, 25-29, 30-34, and 35-39 years). RESULTS: We identified 5,350 AYA patients diagnosed with colorectal cancer. Of note, 28.6% of AYA cases were diagnosed with right-sided tumors (cecum to transverse colon). The proportion of right-sided colorectal cancers differed significantly by age group at diagnosis (38.3% vs 27.3% of AYAs aged 15-19 vs 35-39 years, respectively; P trend = 0.01). Proportions of cases with mucinous adenocarcinoma and signet ring cell carcinoma histopathologic subtypes significantly increased with younger age at onset (P trends = 0.01 and 0.03, respectively). Differences in clinical stage were observed across AYA age groups, with stage II disease increasing with younger age (P trend = 0.01). The proportion of Hispanic AYAs was higher within younger patients, accounting for 21.0% of the AYA population aged 35-39 years up to 28.3% of 15-19-year-old individuals (P trend = 0.003). DISCUSSION: Within the AYA population, colorectal cancers differ by clinicopathologic and racial/ethnic characteristics. Further investigation of the clinical and biologic diversity of colorectal cancers that partially underlie age- and race-related differences in cancer susceptibility and outcomes is warranted.

AB - OBJECTIVES: Despite overall reductions in colorectal cancer burden, incidence rates continue to rise among younger patients, and causes remain unknown. We examined differences in clinicopathologic and racial/ethnic characteristics within the adolescent and young adult (AYA) population diagnosed with colorectal cancer in the United States. METHODS: Using the National Cancer Institute's Surveillance, Epidemiology, and End Results program data, we identified individuals diagnosed with first primary colorectal cancer between ages 15 and 39 years from 2010 to 2015. Adjusted multivariable logistic regression models were used to quantify clinicopathologic and racial/ethnic differences across age at onset subgroups (15-19, 20-24, 25-29, 30-34, and 35-39 years). RESULTS: We identified 5,350 AYA patients diagnosed with colorectal cancer. Of note, 28.6% of AYA cases were diagnosed with right-sided tumors (cecum to transverse colon). The proportion of right-sided colorectal cancers differed significantly by age group at diagnosis (38.3% vs 27.3% of AYAs aged 15-19 vs 35-39 years, respectively; P trend = 0.01). Proportions of cases with mucinous adenocarcinoma and signet ring cell carcinoma histopathologic subtypes significantly increased with younger age at onset (P trends = 0.01 and 0.03, respectively). Differences in clinical stage were observed across AYA age groups, with stage II disease increasing with younger age (P trend = 0.01). The proportion of Hispanic AYAs was higher within younger patients, accounting for 21.0% of the AYA population aged 35-39 years up to 28.3% of 15-19-year-old individuals (P trend = 0.003). DISCUSSION: Within the AYA population, colorectal cancers differ by clinicopathologic and racial/ethnic characteristics. Further investigation of the clinical and biologic diversity of colorectal cancers that partially underlie age- and race-related differences in cancer susceptibility and outcomes is warranted.

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