EP118 - Colorectal Cancer Diagnosis And Outcomes In Elderly Patients

Saturday, May 10, 2025

3:31 PM – 3:36 PM PT

Location: Monitor 3, Sails Pavilion, Upper Level

ePoster Presenter(s)

Fumiko Egawa, MD (she/her/hers)

Colon & Rectal Surgery Fellow
Brown University/Lifespan Health
Providence, RI, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

Paul M. Jennings, DO

Colon and Rectal Surgery Fellow
Brown Health / Lifespan Health
Farmingdale, New Jersey, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
YL

Yao Z. Liu, MD

Resident
Brown University
Providence, Rhode Island, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no relevant relationships with ineligible companies.
EM

Evan Mitchell, MD

General Surgery resident
Brown Univeristy
Providence, Rhode Island, United States

Disclosure information not submitted.
AK

Adam Klipfel, MD

Program director colorectal fellowship
Brown university
Providence, Rhode Island, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
KB

Katherine Baysinger, MD

Colorectal Surgeon
Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States

Disclosure information not submitted.
LR

Leslie Roth, MD

Associate Professor of Surgery
Brown University
Providence, RI, US

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
MV

Matthew D. Vrees, n/a

Associate Surgeon in Chief Miriam Hospital, Associate Professor Warren Alpert medical school at Bro
Miriam Hospital, Brown University
Lincoln, Rhode Island, United States

Disclosure information not submitted.
SS

Steven Schechter, MD

Interim Chief colorectal Surgery, Warren Alpert School of Medicine of Brown University
Brown Surgical Associates
providence, Rhode Island, United States

Disclosure information not submitted.

Senior Author(s)

RG

Rebecca Gologorsky, MD

Colorectal Surgeon
Brown University
Providence, Rhode Island, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Fumiko Egawa, MD: This individual has no financial relationships with ineligible companies.

Paul M. Jennings, DO: This individual has no financial relationships with ineligible companies.

Yao Z. Liu, MD: This individual has no relevant relationships with ineligible companies.

Adam Klipfel, MD: This individual has no financial relationships with ineligible companies.

Leslie Roth, MD: This individual has no financial relationships with ineligible companies.

Rebecca Gologorsky, MD: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Screening colonoscopy is an effective method for colon and rectal cancer prevention and early cancer diagnosis. The incidence of colorectal adenomas and cancers increases with age. Screening guidelines recommend cessation of screening at 75 years except for those in excellent health who may be candidates for cancer treatment. There is a lack of data on patients age ≥75 who present with colon cancer and in patients age ≥75 who have had colonoscopies with polypectomies performed. In this study we evaluate patients age ≥75 who presented to a regional healthcare system and are diagnosed with colon cancer to better understand their clinical characteristics and outcomes in order to inform colon cancer screening recommendations. We hypothesize that patients ≥75 years old would benefit from continued screening to prevent colorectal cancer.

Methods/Interventions: We conducted a retrospective review of patients aged ≥75 who presented to our regional healthcare system between January 2016 and January 2020 for a colon cancer diagnosis. We recorded clinical information such as diagnosis, cancer stage, surgery performed, and 30-day outcomes for each patient. Those with incomplete records were excluded. These findings are described in the context of colon cancer patients younger than 75 years who present for a diagnosis of colon cancer, using Chi-square and student t-test.

Results/Outcomes: 162 patients age ≥75 treated for colon cancer were included. The mean age was 81.3 years, 62.0% were female, and 94% were Caucasian. A majority of patients presented with an alarm symptom (Table 1) concerning for malignancy (53%), the most common of which were anemia (35.2%) and bleeding per rectum (17.9%). Only 8.0% of cancers in this cohort were diagnosed through routine screenings. 16% of patients (N=26) underwent urgent or emergent surgery for their symptoms. Two patients had unresectable disease at diagnosis and did not undergo surgery. 19.7% were diagnosed with stage I colorectal cancer, 40.7% with stage II colorectal cancer, 28% with stage III colorectal cancer, and 6.4% with stage IV colorectal cancer. Of the 160 patients who underwent resection, 81% had a minimally-invasive procedure with a 15.4% rate of open conversion. Post-operatively 13% had unplanned readmission within 30 days and 4% had unplanned return to OR. As compared to a prospectively collected database of all patients treated within our system for colon cancer, elderly were more likely to undergo urgent/emergent operation (1, N=323) = 32.5, p<.05, and presented at a more advanced disease stages (Table 2).

Conclusion/Discussion: There is limited data on colorectal cancer presentation and outcomes in elderly patients. Our results demonstrate that a majority of elderly patients treated within our regional healthcare system do not undergo routine colonoscopy. These patients therefore present more frequently than a younger cohort with symptomatic disease and are more likely to need an urgent/emergent surgery, thereby increasing surgical risk in an already vulnerable population. We believe that continuation of screening, whether by fecal immunohistochemical testing or colonoscopy, is warranted in patients age ≥75.