Shen L, et al. - Among non-metastatic colorectal cancer (CRC) patients, researchers explored the association of age and sex on survival and determined groups at high risk for poor outcomes. The poorest disease-free survival (DFS) and quite poor overall survival (OS) was observed among young female CRC patients (≤35 years old) vs the other age groups. Findings call for health care providers to have a heightened awareness and to conduct further research when caring for young female CRC patients.

• A retrospective analysis of 5,047 non-metastatic CRC patients from 2008 to 2013 was carried out, utilizing data regarding age at diagnosis; gender; tumor site; tumor stage; differentiation; lymphatic, neural or vascular invasion; and survival outcomes.
• Stratification of patients into 10-year age groups (≤35, 36–45, 46–55, 56–65, 66–75, >75) was done followed by further analysis in three age groups (≤35, 36–75, >75).
• Using univariate and multivariate Cox regression models, disease-free survival (DFS) and overall survival (OS) were assessed.

• A total of 5,047 patients were eligible, 41.3% were female.
• Between the genders, the tumor stages were balanced.
• Among the different age groups of female patients, similar distribution of the tumor stages was reported, while younger male patients were diagnosed with more advanced disease (P<0.001 for trend).
• Significantly poorer survival was noted among young females vs young males, when stratified into three age groups (DFS: hazard ratio [HR]=1.85 [1.04–3.30], OS: HR=2.65 [1.11–6.34]).
• Findings demonstrated that after adjusting for tumor stage, site, differentiated grade and lymphatic or vascular invasion status, females ≤35 and >75 had shorter DFS than patients between 36 and 75 years old (HR=1.57 [1.03–2.38] and HR=1.51 [1.11–2.05, respectively]), while there was no difference in DFS between females ≤35 and those >75.
• Older age was found to be related to poorer OS after the same adjustment for male patients.