M. M. Njus1, N. Sharma1, S. Patil1 1Ascension Providence Hospital, Dept. Of General Surgery, Southfield, MI, USA
Introduction: In men and women combined, colorectal cancer is the second most common cause of cancer-related death in the United States. Nationally, incidence of new colon cancer diagnosis is highest among black men, and on average occurs most frequently among people ages 65-74. However, roughly 10% of new cases occur in individuals younger than 50. We examine colorectal cancer trends among the millennial generation defined as anyone born between 1981 and 1996 (currently ages 25-40). We aim to characterize colon cancer malignancies appearing in this younger population via analysis of demographic, clinical, and long-term outcomes.
Methods: The National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database was used to abstract patients with a diagnosis of colon cancer between 1992-2018. Demographic and clinical differences were compared with continuous variables analyzed using ANOVA, and categorical variables with Chi-squared tests. Cumulative life table analysis was used to compare long-term survival.
Results: 13,077 patients were identified. Mean age at presentation was 35.2 ± 4.1 years with no significant gender differences. Colon cancer was more common in white males (71.8%) and black females (15%) compared to respective female (67.9%) and male (12.4%) counterparts, p <0.001. 60% of all patients suffered from local or regionalized disease, while distant spread was higher in females (21.2%) compared to males (20.4%), p <0.01. A higher percent of females (87.2%) received cancer directed surgery (CDS) compared to males (82.7%), p <0.001. Average survival in months was significantly greater for females (94.2 ± 90.1) compared to males (89.0 ± 89.0), p=0.001. Overall, cancer-specific mortality was higher in males (34.5%) compared to females (31.2%), p <0.001. 5-year cancer-specific survival was also greater in females (67%) compared to males (64%).
Conclusion: In the millennial generation, colon cancer is diagnosed at equal rates between men and women and with a greater incidence in white males and black females compared to their corresponding counterparts. Most patients are found to have local or regional disease. A higher percent of female patients received CDS, faced lower cancer-specific mortality, and higher mean 5-year cancer-specific survival, despite slightly higher incidence of distant spread compared to males.
