Sociodemographic Characteristics of Younger Adults Diagnosed with Colorectal Cancer (CRC) Open Access

Abstract

Background: Colorectal cancer (CRC) is the third most common invasive malignant tumor diagnosed in males and second most common in females. Relatively little is known about the typical CRC presentation in pre-screening populations. Approximately 10% of new cases are in adults under the age of 50 years. CRC incidence among adults between 40 and 49 years increased by almost 15% from 2000-2002 to 2014-2016. The purpose of this thesis is to examine factors associated with stage of CRC diagnosis among persons between ages 18 and 44 years. Understanding sociodemographic characteristics of persons who present with advanced disease may offer important opportunities for reducing disparities.

 

Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI) were utilized to obtain research data from 2009-2018. Patients were selected based on primary disease site and morphology codes. All CRC cases newly diagnosed among adult patients of prescreening age (18-44 years) and reported to one of the 21 SEER registries were categorized according to age, race/ethnicity, gender, registry/region, and year of diagnosis. These variables were included in a series of logistic regression models that used various stage-at-diagnosis characteristics as outcomes of interest.

 

Results: Among 28,828 age-eligible CRC patients reported to SEER during the study period 27,607 (95.6%) had known stage disease and among those 17,784 (64.4%) were diagnosed with advanced CRC. The crude and multivariable analyses of factors associated with advanced stage CRC among person with known stage disease were quite similar. Advanced CRC was more likely in persons under age 35 years and persons with undefined race/ethnicity. Similar results were found in the secondary analysis. Outside of the East Coast/Eastern region, patients were less likely to have unknown disease stage.

 

Conclusions: These analyses demonstrate that clinicians may need to pay closer attention to abdominal symptoms in younger patients and especially young females. Future research studies may consider capturing data from all 50 states and incorporate additional markers of social determinants of health as well as examine outcomes of CRC in younger age groups with a specific focus on survival and risk of recurrence.

Table of Contents

Overview: Page 1

Background: Page 2

Problem Statement: Page 5

Purpose Statement: Page 5

Methods: Page 6

Results: Page 8

Discussion: Page 10

Conclusions: Page 15

References: Page 16

Tables: Page 20

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Executive Masters of Public Health - MPH
Subfield / Discipline	Applied Public Health Informatics
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	colorectal cancer
Committee Chair / Thesis Advisor	Michael Goodman, Emory University
Committee Members	Alex Edwards, Emory University

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