National Data on Colorectal Cancer Trends: A Population-Based Study in Taiwan

Abstract

Purpose. The prognosis of patients having different ages at the onset of colorectal cancer (CRC) is controversial. The aim of this study was to complete a comprehensive analysis of the relationship between age differences and CRC survival using population registries from Taiwan.Methods. For patients diagnosed with CRC between 1998 and 2005, we analyzed survival data derived from the Taiwan Cancer Registry database. During this time period, 65,113 patients were registered, and 62,060 patients, presenting definite histological evidence of adenocarcinoma, mucinous adenocarcinoma, or signet-ring cell carcinoma of the colon and rectum, were enrolled into this cohort study. Age differences in pathological characteristics and prognosis were analyzed.Results. From 1998 to 2005, the proportion of patients diagnosed at a younger age (≤ 40-years-of-age group) decreased from 6.8% to 4.6%. Until 2000, most individuals in the CRC patient group were in the sixth and seventh decade. Individuals in the seventh and eighth decade replaced this group after 2000, and became the majority. Younger patients (≤40-years-of-age group) had a higher incidence of mucinous adenocarcinoma (p ＜ 0.001) and signet-ring cell carcinoma (p ＜ 0.001), and poorer 1-year, 3-year, 5-year overall survival (p ＜ 0.001) and cancer-specific survival (p ＜ 0.001) than elderly patients (the 41-50, 51-60, and 61-70 year groups).Conclusions. National data on colorectal cancer trends clearly indicate that currently, in Taiwan, colorectal cancer rates are not showing an increase in younger generations. More aggressive histopathologic characteristics and poorer overall and cancer-specific survival were noted in younger, as compared to older CRC patients.