Clinical Characteristics and Outcomes of Colorectal Cancer in Elderly Patients

Aims A large part of patients with colorectal cancer (CRC) are diagnosed at elderly age. We aimed to investigate the clinical, endoscopic and outcomes of patients diagnosed with CRC at age 75 years and older (late onset CRC, LOCRC) compared to young people

Methods We included patients with confirmed CRC in a single tertiary center setting between the years 2003 and 2023. Data regarding demographics, indications, comorbidities, endoscopic data and laboratories were collected.

Results we compared the data of 903 (29.6) LOCRC patients aged 75 years or older to 2143 younger patients. Average age of LOCRC patients (80.1±4 vs. 61.4±10 years, p<0.001), 49.2% females. Smoking was more prevalent among younger patients (23.4% vs. 18.6%, p=0.006). Rectal bleeding as indication was less common in LOCRC (21.9% vs 63.1%, p<0.001), while constipation (18.2% vs. 8.4%, p<0.001) and anemia (28.3 vs 13.4, p<0.001) were more prevalent. Cancer localization differed, with older patients more likely to have right colon cancer (43.9% vs. 33.7%, p<0.001). Disease staging showed a higher proportion of younger patients in Stage IV (22.4% vs. 17.8%, p=0.005), while older patients were more often in Stage II (31.3% vs. 27.6%, p=0.036). Surgical intervention was more frequent among older patients (86.2% vs. 71.2%, p<0.001). the Mortality rate was found to 68.2% in LOCRC compared to 40.7%.

Conclusions The study highlights the differences in clinical and endoscopic characteristics of CRC in the elderly age. Ris stratification, personalized screening, expanding the screening age and special consideration are needed among elderly patients.

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Artikel online veröffentlicht:
27. März 2025