title: Does young age influence the prognosis of colorectal cancer: a population-based analysis.
abstract: BACKGROUND
  Controversy exists whether young patients diagnosed with colorectal cancer have a poorer prognosis. Although younger patients are more likely to have certain poor prognostic factors, prior studies have shown mixed results in terms of overall prognosis, which may be due to lack of adjustment for confounding factors. The primary objective of our study was to determine the effect of age on survival following treatment of colorectal cancer in the Province of Manitoba, Canada, while controlling for important cofactors.
  
  
  METHODS
  This was a population-based analysis of all adult patients (age≥18 years) diagnosed with adenocarcinoma of the colon or rectum between 1 January 2004 and 31 December 2006 in the Province of Manitoba. Patient, tumor, and treatment factors were identified using administrative data. Five-year Kaplan-Meier survival and Cox proportional hazards model were analyzed to determine whether young age (45 years of age or younger) was associated with a poorer prognosis, while controlling for confounding variables.
  
  
  RESULTS
  Of the 2,086 patients identified, 70 (3.36%) were considered young. These patients were more likely to have T4 tumors and node-positive disease. Older patients had more advanced comorbidities. Young age was an independent predictor of better survival. Poorer survival was associated with male gender, increasing stage, higher grade, comorbidity, lower socioeconomic status, and lack of receipt of surgery or chemotherapy.
  
  
  CONCLUSIONS
  Young people make up a small minority of patients with colorectal cancer. Young patients present with more locally advanced colorectal cancer. Despite this, on a population basis, their prognosis may be more favorable than their older counterparts when controlling for disease, patient, and treatment factors.
authors.affiliation: Department of Surgery, University of Manitoba, GF-441, 820 Sherbrook St, Winnipeg, MB R3A 1R9, Canada. amckay3@exchange.hsc.mb.ca.
authors.forename: Andrew
authors.initials: A
authors.lastname: McKay
authors.forename: Jeniva
authors.initials: J
authors.lastname: Donaleshen
authors.forename: Ramzi M
authors.initials: RM
authors.lastname: Helewa
authors.forename: Jason
authors.initials: J
authors.lastname: Park
authors.forename: Debrah
authors.initials: D
authors.lastname: Wirtzfeld
authors.forename: David
authors.initials: D
authors.lastname: Hochman
authors.forename: Harminder
authors.initials: H
authors.lastname: Singh
authors.forename: Donna
authors.initials: D
authors.lastname: Turner
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult