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<p>The prognostic association between age and colorectal cancer (CRC) survival may vary by stage. We analyzed adults with microscopically confirmed CRC diagnosed during 2004–2022 in the Surveillance, Epidemiology, and End Results database after excluding appendiceal primaries, death certificate-only/autopsy-only cases, and non-microscopically confirmed cases. Multivariable Cox models assessed age continuously, and age-by-stage interaction models compared patients aged 18–49 versus ≥ 50 years among those with known stage. The primary survival cohort included 454,216 patients; multivariable Cox models were fitted in 452,739 patients. Increasing age was associated with worse cancer-specific survival (CSS; HR 1.0279/year, 95% CI 1.0275–1.0284) and overall survival (OS; HR 1.0443/year, 95% CI 1.0440–1.0447). Age-by-stage interaction was significant for both endpoints. For CSS, the association of age ≥ 50 years was strongest in localized disease (HR 2.17, 95% CI 2.04–2.31) and attenuated in regional (HR 1.58, 95% CI 1.54–1.63) and distant disease (HR 1.41, 95% CI 1.38–1.44), with a similar pattern for OS. Older age was associated with worse CRC survival, but the magnitude of this association was stage-dependent.</p>

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Stage-dependent prognostic impact of age in colorectal cancer: A population-based SEER analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月17日

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  • Burak Pacaci,
  • Ibrahim Vedat Bayoglu

摘要

The prognostic association between age and colorectal cancer (CRC) survival may vary by stage. We analyzed adults with microscopically confirmed CRC diagnosed during 2004–2022 in the Surveillance, Epidemiology, and End Results database after excluding appendiceal primaries, death certificate-only/autopsy-only cases, and non-microscopically confirmed cases. Multivariable Cox models assessed age continuously, and age-by-stage interaction models compared patients aged 18–49 versus ≥ 50 years among those with known stage. The primary survival cohort included 454,216 patients; multivariable Cox models were fitted in 452,739 patients. Increasing age was associated with worse cancer-specific survival (CSS; HR 1.0279/year, 95% CI 1.0275–1.0284) and overall survival (OS; HR 1.0443/year, 95% CI 1.0440–1.0447). Age-by-stage interaction was significant for both endpoints. For CSS, the association of age ≥ 50 years was strongest in localized disease (HR 2.17, 95% CI 2.04–2.31) and attenuated in regional (HR 1.58, 95% CI 1.54–1.63) and distant disease (HR 1.41, 95% CI 1.38–1.44), with a similar pattern for OS. Older age was associated with worse CRC survival, but the magnitude of this association was stage-dependent.