e19521 Background: CRC is the third most common cancer in both men and women in the United States. The median age at diagnosis is 70 years and fewer elderly patients (pts) receive CT. Controversy exists in the literature regarding benefit from CT in the elderly. We performed a retrospective study to evaluate CT and its benefit in different age groups. Methods: Data on pts diagnosed with CRC from 1993-2008 were collected from the Cancer Information Resource File. Complete data on age, gender, stage, tumor characteristics, treatment, and overall survival (OS) were available on 32,177 pts and were analyzed by age in four categories: < 50, 50-69, 70-79, and ≥ 80 years. Results: Of 32,177 pts, 7% were < 50, 35% were 50-69, 32% were 70-78, and 26% were ≥ 80 yrs. Table IA reports patient demographics, IB reports median OS (MOS) by age and stage, and IC reports rates of CT by age and stage. As reported in the table, use of CT declined with advancing age, regardless of stage. Multivariate Cox regression analysis showed that all age categories benefited from CT [< 50 years HR 0.75, 50-69 years HR 0.61, 70-79 years HR 0.53, and ≥ 80 years HR 0.55 (all p < 0.01)] after simultaneously adjusting for age at time of diagnosis, gender, race, stage, and grade. Conclusions: Older pts receive CT less frequently than younger pts. The elderly significantly benefit from CT. Younger pts were more likely to present with stage IV disease when compared to the elderly. Randomized, prospective trials are required to explore the differences noted. Table 1A Patient demographics. Age categories (years) <50 50-69 70-79 >80 Total Gender (%) Male 48 53 48 38 47 Female 52 47 52 62 53 AJCC stage (%) I 12 20 23 22 21 II 28 29 35 40 34 III 35 32 29 27 30 IV 25 19 13 11 15 Grade (%) I 9 10 10 9 10 II 67 71 70 68 69 III 23 18 19 22 20 IV 1 1 1 1 1 <12 LN examined (%) 68 58 54 53 56 CT received (%) 66 49 31 11 35 Table IB MOS in months by stage and age groups <50 50-69 70-79 >80 Total AJCC stage I NR 128 102 59 NR II NR NR 79 46 98 III 116 97 50 26 61 IV 20 19 13 7 36 Table IC CT by stage and age groups <50 50-69 70-79 >80 AJCC (%) stage I 9 2 2 1 II 55 35 16 3 II* 64 41 20 4 III 86 80 63 24 IV 79 69 52 25 * Patient who meets criteria for CT (T4, grade 3 or 4, or <12 LNs examined). Abbreviations: AJCC, American Joint Committee on Cancer; LN, lymph node; NR, not reached.