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Cancer. Author manuscript; available in PMC 2017 March 15. Published in final edited form as: Cancer. 2016 March 15; 122(6): 929–934. doi:10.1002/cncr.29716.

Colorectal Cancer Outcomes and Treatment Patterns in Patients Too Young for Average-Risk Screening Zaid Abdelsattar, MD, MSc1,3, Sandra Wong, MD, MS1, Scott Regenbogen, MD, MPH1, Diana Jomaa2, Karin Hardiman, MD, PhD1, and Samantha Hendren, MD, MPH1 1Center

for Healthcare Outcomes & Policy, Department of Surgery, University of Michigan, Ann Arbor MI

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2College

of Literature, Science and the Arts, University of Michigan, Ann Arbor MI

3Department

of Surgery, Mayo Clinic, Rochester MN

Abstract Background—The proportion of cancer cases in younger patients is increasing though colorectal cancer (CRC) screening guidelines recommend starting at age 50. The national treatment patterns and outcomes of these patients are largely unknown.

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Methods—This is a population-based retrospective cohort study of the nationally representative Surveillance, Epidemiology, and End Results registry for patients diagnosed with CRC from 1998-2011. Patients were categorized as being younger or older than the recommended screening age. Differences in stage at diagnosis, patterns of therapy, and disease-specific survival were compared between age groups using multinomial regression, multiple regression, cox-proportional hazards regression, and Weibull survival analysis. Results—Of 258,024 CRC patients, 37,847 (15%) were younger than 50. Young patients were more likely to present with regional (Relative risk ratio [RRR]: 1.3, p