Clinical and pathologic characteristics of early-onset colorectal cancer (EoCRC).
Bibliographic record
Abstract
72 Background: Although CRC incidence continues to fall in patients over 50 due to adoption of screening programs, there has been an increasing incidence in patients < 50 where screening does not occur. We investigated the clinical and pathologic characteristics of EoCRC in BC. Methods: We retrospectively analyzed 27612 patients diagnosed with CRC and referred to BC Cancer between 1990-2016. Patients < 50 were classified as early onset CRC and analyzed for baseline and disease characteristics. Results: In the 2540/27612 (9.2%) of patients < 50, patients were more likely to be female (OR 1.33, 95% CI 0.61-1.44, P < 0.0001), have left sided tumors (OR 1.50, 95% CI 1.35-2.01, P < 0.0001), have poorly differentiated tumors (OR 1.24, 95% CI 1.10-1.34, P = 0.0003), and more patients presented with metastatic disease (OR 1.26, 95% CI 1.15-1.38, P < 0.0001) compared to patients ≥50. At diagnosis, patients < 50 were more likely to have a significant complication related to the primary tumor (OR 1.18, 95% CI 1.06-1.32, P = 0.0041), specifically, greater rates of perforation (OR 1.84, 95% CI 1.47-2.31, P < 0.0001). Although high risk features used to guide adjuvant therapy decisions in patients < 50 with stage II CRC were not higher, with similar T4 prevalence, poor differentiation, lymphovascular and perineural invasion, and less inadequate lymph node harvesting (≤12) (all p > 0.05), rates of adjuvant therapy were higher (OR 2.39, 95% CI 1.91-3.00, P < 0.0001). This was also noted in stage III CRC (OR 4.11 95% CI 3.07-5.48, P < 0.0001). Age impacted overall survival, with younger patients of all stages living longer (HR 0.72, 95% CI 0.68-0.76, P < 0.0001). Similar findings were noted for stage I-III CRC (HR 0.54 0.50-0.58, P < 0.0001) and for patients once they became metastatic (HR 0.84 95% CI 0.75-0.93, P = 0.0025). To control for competing causes of death, we looked at disease specific survival, which continued to show improved outcomes for patients age < 50 in stage I-III (HR 0.88 95% CI 0.81-0.97, P = 0.0016) and stage IV (HR 0.77 95% CI 0.72-0.84, P < 0.0001) CRC. Conclusions: EoCRC patients present with unique clinical and pathologic characteristics which may impact outcome. While the population < 50 has comparable outcomes, they may undergo increased rates of treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".