Assessing Presenting Symptoms, Co-Morbidities, and Risk Factors for Mortality in Underserved Patients with Non-Hereditary Early-Onset Colorectal Cancer

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dc.contributor.authorReddy, Shravanien
dc.contributor.authorMouchli, Awfen
dc.contributor.authorBierle, Lindseyen
dc.contributor.authorGerrard, Mirandaen
dc.contributor.authorWalsh, Christopheren
dc.contributor.authorMir, Adilen
dc.contributor.authorLebel, David P.en
dc.contributor.authorMason, Christopheren
dc.contributor.authorGrider, Douglas J.en
dc.contributor.authorRubio, Marrieth G.en
dc.date.accessioned2022-04-26T11:53:04Zen
dc.date.available2022-04-26T11:53:04Zen
dc.date.issued2021-07-02en
dc.date.updated2022-04-25T17:41:01Zen
dc.description.abstractBackground: The presenting symptoms and co-morbidities contributing to mortality in young patients (age < 50 years old) with colorectal cancer (CRC) are poorly understood. We reviewed these features in our patient population with non-hereditary early-onset CRC (EO-CRC). Study aim: This study aimed to assess characteristics of patients with a diagnosis of non-hereditary EO-CRC, including presenting symptoms and metabolic disorders contributing to mortality in underserved areas of southwest Virginia. Methods: In this retrospective observational study, we selected patients aged 18-50 years with a diagnosis of non-hereditary EO-CRC from 2008 to 2016 at Carilion Roanoke Memorial Hospital. The electronic medical record was queried to identify demographic data, medical history, histopathology results, lab values, and mortality. The cumulative risks of symptoms and co-morbid metabolic disorders was estimated using Kaplan-Meier curves. Results: We identified 139 patients with non-hereditary EO-CRC (mean age 41.6 ± 6.9 years). Almost half of these patients were obese (BMI > 30), 30.9% had a diagnosis of hypertension, 29% had hyperlipidemia (HLD), and 17.35% had diabetes mellitus type 2 (DM2). Diagnosis was delayed by 4.5 months from initial presentation, and 17% had advanced disease (stage III/IV). Also, 68.5% of patients were symptomatic with one to three symptoms, most commonly with rectal bleeding (45.3%). The chronicity of HLD (≥5 years) was associated with reduced survival in our patients with EO-CRC. The survival of females with multiple metabolic disorders was reduced compared to females with a single metabolic disorder. Conclusions: Multiple symptoms, chronic HLD, and female gender with multiple metabolic disorders were factors associated with poor outcomes in non-hereditary EO-CRC patients.en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.7759/cureus.16117en
dc.identifier.eissn2168-8184en
dc.identifier.issn2168-8184en
dc.identifier.issue7en
dc.identifier.orcidRubio, Marrieth [0000-0001-7503-2822]en
dc.identifier.otherPMC8325966en
dc.identifier.pmid34350080en
dc.identifier.urihttp://hdl.handle.net/10919/109743en
dc.identifier.volume13en
dc.language.isoenen
dc.publisherCureusen
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/34350080en
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectclinical symptomsen
dc.subjectco-morbid conditionsen
dc.subjectearly-onset colorectal canceren
dc.subjectrectal bleedingen
dc.subjectrisk factorsen
dc.titleAssessing Presenting Symptoms, Co-Morbidities, and Risk Factors for Mortality in Underserved Patients with Non-Hereditary Early-Onset Colorectal Canceren
dc.title.serialCureusen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherArticleen
dcterms.dateAccepted2021-06-21en
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Internal Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Basic Scienceen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Basic Science/Basic Scienceen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Internal Medicine/General IMen

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