Skip to main content
SpringerLink
Log in

Clinical features of colorectal cancer patients in advanced age: a population-based approach

  • IM - ORIGINAL
  • Published:
Internal and Emergency Medicine Aims and scope Submit manuscript

Abstract

In the immediate future, the number of geriatric patients will continue to rise; consequently we should expect an increase of colorectal cancer, a disease of the elderly population. Through the data of a Cancer Registry, we examined (a) the effect of ageing on the main features of colorectal cancer; (b) changes in management, especially for individuals older than 80 years; and (c) changes in prognosis and survival in subgroups of patients with different age. The Registry provided information on colorectal cancer up to 2010 (27 years). A total of 5293 patients were registered; these were divided into three groups: A (0–64 years), B (65–79) and C (80 or more). Three periods of observation were chosen: 1 (1984–1992), 2 (1993–2001) and 3 (2001–2010). Group A included 1571 patients (29 %), Group B 2539 (48 %) and Group C 1183 (22.3 %). The fraction of old individuals increased during the 27 years of the investigation. In these patients, tumours were predominantly localized to the right colon (42.6 %). The rate of surgery and ratio between curative and palliative approaches were similar among the three groups (p < 0.38). There was disparity (p < 0.002) in the administration of chemotherapy (5.8 % of the elderly vs 34.4 % in remaining patients). Survival increased over time in all three groups. In the elderly, average 5-year survival was 31 % in period 1 and 55 % in period 3. These data show that in Western countries, the standard of care for colorectal cancer diagnosed in geriatric patients has improved over the last 30 years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Center MM, Jemal A, Ward E (2009) International trends in colorectal cancer incidence rates. Cancer Epidemiol Biomarkers Prev 18:1688–1694

    Article  PubMed  Google Scholar 

  2. AIRTum Working Group (2006) I tumori in Italia – Rapporto 2006: incidenza, Mortalità e Stime. Epidemiologia e Prevenzione, suppl. 1:1–147

    Google Scholar 

  3. Piñeros M, Hernández G, Bray F (2004) Increasing mortality rates of common malignancies in Colombia: an emerging problem. Cancer 101:2285–2292

    Article  PubMed  Google Scholar 

  4. Mueller-Koch Y, Vogelsang H, Kopp R, Lohse P, Keller G, Aust D et al (2005) Hereditary non-polyposis colorectal cancer: clinical and molecular evidence for a new entity of hereditary colorectal cancer. Gut 54:1733–1740

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Chao A, Thun MJ, Connell CJ, McCullough ML, Jacobs EJ, Flanders WD et al (2005) Meat consumption and risk of colorectal cancer. JAMA 293:172–182

    Article  CAS  PubMed  Google Scholar 

  6. Lee IM, Paffenbarger RS Jr, Hsieh CC (1992) Physical activity and risk of prostatic cancer among college alumni. Am J Epidemiol 135:169–179

    CAS  PubMed  Google Scholar 

  7. Gerhardsson de Verdier M, Steineck G, Hagman U, Rieger A, Norell SE (1990) Physical activity and colon cancer: a case-referent study in Stockholm. Int J Cancer 46:985–989

    Article  CAS  PubMed  Google Scholar 

  8. Ponz de Leon M, Sacchetti C, Zanghieri G et al (1987) Epidemiologia dei tumori dell’apparato digerente nella U.S.L. 16. A cura della Lega Italiana per la Lotta contro i Tumori 1–80

  9. Ponz de Leon M, Sassatelli R, Sacchetti C, Zanghieri G, Scalmati A, Roncucci L (1989) Familial aggregation of tumors in the three-year experience of a population-based colorectal cancer registry. Cancer Res 49:4344–4348

    CAS  PubMed  Google Scholar 

  10. Ponz de Leon M, Benatti P, Pedroni M, Sassatelli R, Roncucci L (1993) Risk of cancer revealed by follow-up of families with hereditary non-polyposis colorectal cancer: a population-based study. Int J Cancer 55:202–207

    Article  CAS  PubMed  Google Scholar 

  11. Stefánsson T, Ekbom A, Sparèn P, Påhlman L (1993) Increased risk of left sided colon cancer in patients with diverticular disease. Gut 34:499–502

    Article  PubMed  PubMed Central  Google Scholar 

  12. Cucino C, Buchner AM, Sonnenberg A (2002) Continued rightward shift of colorectal cancer. Dis Colon Rectum 45:1035–1040

    Article  PubMed  Google Scholar 

  13. Troisi RJ, Freedman AN, Devesa SS (1999) Incidence of colorectal carcinoma in the U.S.: an update of trends by gender, race, age, subsite, and stage, 1975-1994. Cancer 85:1670–1676

    Article  CAS  PubMed  Google Scholar 

  14. WHO World Health Organization (2000) International statistical classification of diseases and related health problems. Tenth Revision (ICD-10). Geneve

  15. Dworak O, Keilholz L, Hoffmann A (1997) Pathological features of rectal cancer after preoperative radiochemotherapy. Int J Colorectal Dis 12:19–23

    Article  CAS  PubMed  Google Scholar 

  16. Cleves M, Gould WM, Gutierrez RG (2002) An introduction to survival analysis using stata. Stata Press, College Station, pp 7–34

    Google Scholar 

  17. Bouvier AM, Remontet L, Jougla E, Launoy G, Grosclaude P, Buémi A et al (2004) Incidence of gastrointestinal cancers in France. Gastroenterol Clin Biol 28:877–881

    Article  PubMed  Google Scholar 

  18. Extermann M, Aapro M, Bernabei R, Cohen HJ, Droz JP, Lichtman S et al (2005) Task Force on CGA of the International Society of Geriatric Oncology. Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol 55:241–252

    Article  PubMed  Google Scholar 

  19. Patel SS, Nelson R, Sanchez J, Lee W, Uyeno L, Garcia-Aguilar J et al (2013) Elderly patients with colon cancer have unique tumor characteristics and poor survival. Cancer 119:739–747

    Article  PubMed  Google Scholar 

  20. Mensink PB, Kolkman JJ, Van Baarlen J, Kleibeuker JH (2002) Change in anatomic distribution and incidence of colorectal carcinoma over a period of 15 years: clinical considerations. Dis Colon Rectum 45:1393–1396

    Article  CAS  PubMed  Google Scholar 

  21. Takada H, Ohsawa T, Iwamoto S, Yoshida R, Nakano M, Imada S et al (2002) Changing site distribution of colorectal cancer in Japan. Dis Colon Rectum 45:1249–1254

    Article  PubMed  Google Scholar 

  22. Kim GM, Ahn JB, Rha SY, Kim HS, Kang B, Kim MW et al (2013) Changing treatment patterns in elderly patients with resectable colon cancer. Asia Pac J Clin Oncol 9:265–272

    Article  PubMed  Google Scholar 

  23. Mastracci TM, Hendren S, O’Connor B, McLeod RS (2006) The impact of surgery for colorectal cancer on quality of life and functional status in the elderly. Dis Colon Rectum 49:1878–1884

    Article  PubMed  Google Scholar 

  24. Aparicio T, Navazesh A, Boutron I, Bouarioua N, Chosidow D, Mion M et al (2009) Half of elderly patients routinely treated for colorectal cancer receive a sub-standard treatment. Crit Rev Oncol Hematol 71:249–257

    Article  PubMed  Google Scholar 

  25. Kunitake H, Zingmond DS, Ryoo J, Ko CY (2010) Caring for octogenarian and nonagenarian patients with colorectal cancer: what should our standards and expectations be? Dis Colon Rectum 53:735–743

    Article  PubMed  Google Scholar 

  26. Benatti P, Gafà R, Barana D, Marino M, Scarselli A, Pedroni M et al (2005) Microsatellite instability and colorectal cancer prognosis. Clin Cancer Res 11:8332–8340

    Article  CAS  PubMed  Google Scholar 

  27. Chen RC, Royce TJ, Extermann M, Reeve BB (2012) Impact of age and comorbidity on treatment and outcomes in elderly cancer patients. Semin Radiat Oncol 22:265–271

    Article  PubMed  Google Scholar 

  28. Wolpin BM, Mayer RJ (2008) Systemic treatment of colorectal cancer. Gastroenterology 134:1296–1310

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Esteva M, Ruiz A, Ramos M, Casamitjana M, Sánchez-Calavera MA, González-Luján L et al (2014) DECCIRE GROUP. Age differences in presentation, diagnosis pathway and management of colorectal cancer. Cancer Epidemiol 38:346–353

    Article  PubMed  Google Scholar 

Download references

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with human and animals performed by any of the authors.

Informed consent

None.

Author information

Authors and Affiliations

  1. Medicina 1, Dipartimento di Medicina Diagnostica, Clinica e Sanità Pubblica, Università di Modena e Reggio Emilia, Policlinico, Via del Pozzo n.71, 41100, Modena, Italy

    Stefania Maffei, Alessandra Colantoni, Piero Benatti, Ester Tesini & Maurizio Ponz de Leon

  2. Unità di Statistica in Medicina, Dipartimento di Medicina Diagnostica, Clinica e Sanità Pubblica, Università di Modena e Reggio Emilia, Modena, Italy

    Shaniko Kaleci

Authors
  1. Stefania Maffei
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessandra Colantoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shaniko Kaleci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Piero Benatti
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ester Tesini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maurizio Ponz de Leon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maurizio Ponz de Leon.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maffei, S., Colantoni, A., Kaleci, S. et al. Clinical features of colorectal cancer patients in advanced age: a population-based approach. Intern Emerg Med 11, 191–197 (2016). https://doi.org/10.1007/s11739-015-1286-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11739-015-1286-5

Keywords

Search

Navigation