Risk Factors for Diagnosis of Colorectal Cancer at a Late Stage: a Population-Based Study

BackgroundLate-stage colorectal cancer (CRC) is associated with significantly less effective treatment and poorer survival than early-stage colorectal cancer.ObjectiveIdentify and assess patient characteristics, demographic factors, and lifestyle factors that are associated with late-stage colorectal cancer at diagnosis.ApproachWe linked two longstanding statewide, population-based registry databases: the New Hampshire Colonoscopy Registry and the New Hampshire State Cancer Registry, to assess the associations between patient characteristics and late-stage CRC diagnoses. The State Cancer Registry provided information on cancer stage and the Colonoscopy Registry provided detailed information on patient characteristics and lifestyle factors, allowing these factors to be analyzed in relation to colorectal cancer stage.Key ResultsThe risk of late-stage CRC diagnosis was highest among those diagnosed at a young age (<50years old) (OR 1.81, 95% CI 1.27-2.58). Those with Medicaid were also at increased risk, particularly <65years of age (OR 2.32, 95% CI 1.05-5.26). A family or personal history of polyps and/or CRC was associated with early stage at diagnosis (p=0.014).ConclusionsPublic health outreach and screening efforts should focused on patients at risk of late-stage CRC to encourage earlier diagnosis and prevention. Underserved patients have a lower rate of CRC screening and an increased risk of late-stage CRC, emphasizing the critical need to reach these populations. Further investigation of susceptibility characteristics and the effectiveness of non-invasive early screening techniques is warranted to address the late-stage CRC diagnoses in young individuals.