Younger age at onset of colorectal cancer is associated with increased patient's delay

AIM: This study aimed to investigate if younger age at diagnosis of colorectal cancer was associated with a diagnostic delay. The secondary objective was to evaluate if symptomatology varied with age.

METHOD: The study population consisted of the cohorts from two prospective multicentre studies conducted in Sweden and Denmark, the QoLiRECT and QoLiCOL studies. These studies investigated the quality of life in patients with colorectal cancer. Participants responded to the validated questionnaires used to extract information on patient's and doctor's delay as well as first presenting symptoms. Clinical variables were retrieved from the Swedish Colorectal Cancer Registry and the Danish Colorectal Cancer Group Database.

RESULTS: 2574 patients were included, 1085 from QoLiRECT and 1489 from QoLiCOL. The probability of an increased patient's delay was higher when age decreased by 10 years (the SD in both QoLiRECT and QoLiCOL), adjusted OR 1.19 (95%CI: 1.10; 1.30), p < 0.001. A similar effect was found for doctor's delay, but the age effect was smaller in this case, adjusted OR 1.05 (95%CI: 0.97; 1.15), p = 0.177. When the age effect was analysed non-linearly, an increased probability of a delay was seen for patients from around 60 years and below. Younger patients were equally or more likely to report the symptoms of blood in stool, diarrhoea, constipation, mucus in faeces, faecal urgency, faecal emptying difficulties and pain compared to older patients.

CONCLUSION: Younger patients were more likely to have an increased patient's delay, probably contributing to a delayed diagnosis of colorectal cancer. Symptomatology at diagnosis was similar irrespective of age.