Analysis of early onset colorectal cancer: Implications for research and clinical practice.
Bibliographic record
Abstract
3606 Background: Young onset colorectal cancer(YOCRC), diagnosed < 50 years old, presents distinct challenges, including life transitions, and psychosocial needs. In Alberta, Canada an Adolescent and Young Adult(AYA) program was introduced at our tertiary cancer centres to address these unique needs through tailored resources and services. This study aimed to explore the YOCRC patients' adjuvant care experiences and describe resource utilization prior to and after the AYA program was established. Methods: A retrospective review of YOCRC patients diagnosed with StageIII disease from 2012-2022 and referred to Cancer Care Alberta for adjuvant therapy was performed. This study evaluated the adjuvant care experiences of YOCRC patients, focusing on demographics, tumor characteristics, toxicity, and psychosocial visits. Incidence rates over time was assessed using Joinpoint regression. The Edmonton Symptom Assessment System(ESAS) scores collected during treatment visits were used to characterize symptomatic concerns. Analysis included descriptive statistics and multivariate regression analysis. Results: Among 576 patients, the mean age at diagnosis was 42.9 years. There was a positive trend in incidence of diagnoses per year(p < 0.0001), with an increase in diagnosis of 3.96%(CI 1.30-7.13) per year in patients aged 40-49. Patients with stages IIIB disease were older at time of diagnosis compared to stage IIIC(p = 0.025). Higher stages had poorer outcomes with stage IIIA, IIIB and IIIC(p < 0.001), however median survival was not reached for any stages due to a low death rate. Patients reported psychological related symptoms(well-being, sleep problems and tiredness) more commonly than physical symptoms. Psychosocial visits increased after AYA program initiation with annual rates rising from 7.8 visits/year(pre-AYA program implementation) to 24 visits/year(post-AYA implementation). Further, patients who attended psychosocial visits were more likely to be younger(p < 0.001) and had higher overall mortality(p < 0.001). Of patients with an ESAS of ≥4, patients who were 40-49 were more likely to attend psychosocial service appointments than those aged 20-39, odds ratio of 3.23(95% CI: 1.28-8.78). There was no difference comparing patients attending psychosocial visits or higher ESAS score with sex or stage. Conclusions: Stage III YOCRC patients are increasing in Alberta. An AYA program can improve resource utilization, psychosocial support, and enhance visit frequency for this population with unique needs. Greater prominence of psychological symptoms on ESAS highlight areas that could benefit from focused resources for this population. Demographics of stage III YOCRC patients. Demographics n=576 Sex Male 320 Female 256 Site Colon 291 Rectum 245 Rectosigmoid 40 Stage (AJCC 7) IIIA 52 IIIB 348 IIIC 171 IIINOS 3 Incidence Year 2012 46 2013 40 2014 41 2015 55 2016 43 2017 50 2018 50 2019 61 2020 52
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.020 | 0.060 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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".