Right sided colorectal cancer increases with age and screening should be tailored to reflect this: a national cancer dat
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ORIGINAL ARTICLE
Right sided colorectal cancer increases with age and screening should be tailored to reflect this: a national cancer database study T. Reif de Paula1 · H.L. Simon1 · M.M. Profeta da Luz1 · D. S. Keller1 Received: 5 April 2020 / Accepted: 10 August 2020 © Springer Nature Switzerland AG 2020
Abstract Background In the United States, colorectal cancer (CRC) screening and surveillance is recommended until age 75. However, rates of surgery for CRC are greatest in the elderly, questioning current guidelines. Tumor sidedness is an emerging prognostic marker that may help guide screening and treatment decisions, with specific benefit evaluating CRC anatomic distribution in the elderly. Our objective was to investigate the anatomical distribution of CRC in the elderly and factors associated with right-sidedness. Methods The National Cancer Database (2004–2016) was used to identify elderly patients with CRC. Cases were stratified by tumor sidedness and elderly subgroups: 65–74, 75–84, and ≥ 85 years of age, and further categorized by primary site. Multivariate analysis identified factors associated with CRC right-sidedness. The outcomes were CRC sidedness in the elderly, the anatomic distribution by age group, and factors associated with right-sidedness. Results There were 508,219 colorectal cancer patients aged over 65 years identified, 54% of whom had a right-sided cancer. The right-sided incidence rates by age group were 49% (65–74 years), 58.2% (75–84 years), and 65.9% (≥ 85 years) (p
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