EP638 - Temporal Trends in the Cause of Death of Colon Cancer Patients

Monday, May 12, 2025

8:38 AM – 8:43 AM PT

Location: Monitor 5, Sails Pavilion, Upper Level

ePoster Presenter(s)

Lauren Weaver, MD

Resident
University of Minnesota
University of Minnesota
Minneapolis, MN, United States

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

Author(s)

Catherine Tran, MD (she/her/hers)

Colorectal Surgery Fellow
University of Minnesota
Minneapolis, MN, United States

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

Sarah Mott, MS

Biostatistician
University of Iowa Holden Comprehensive Cancer Center
Iowa City, Iowa, United States

Disclosure information not submitted.
Alexander M. Troester, MD (he/him/his)

General Surgery Resident
University of Minnesota
University of Minnesota
Minneapolis, MN, United States

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

General Surgery Research Resident
University of Minnesota
Minneapolis, MN, United States

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

Schelomo Marmor, PhD

Associate Professor
University of Minnesota
Minneapolis, Minnesota, United States

Disclosure information not submitted.
AP

Ajay Prakash, MD, PhD

Assistant Professor
University of Minnesota
Minneapolis, Minnesota, United States

Disclosure information not submitted.

Senior Author(s)

PG

Paolo Goffredo, MD (he/him/his)

Assistant Professor
University of Minnesota
Minneapolis, MN, 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.

Lauren Weaver, MD: This individual has no financial relationships with ineligible companies.

Catherine Tran, MD: This individual has no financial relationships with ineligible companies.

Alexander M. Troester, MD: This individual has no financial relationships with ineligible companies.

Julia Frebault, MD: This individual has no financial relationships with ineligible companies.

Paolo Goffredo, MD: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Colon cancer remains the third leading cause of cancer-related deaths in the United States. However, with timely and appropriate treatment, a substantial number of patients achieve a cure. With the lowering of the colorectal screening age to 45 years, increasing use of systemic treatment, and the emergence of novel diseases such as COVID-19, trends in mortality for colorectal patients have changed over the past two decades. The current study aimed to identify the main causes of death (COD) following a colon cancer diagnosis.

Methods/Interventions: The Surveillance, Epidemiology, and End Results (SEER) database was queried for adult patients diagnosed with colon adenocarcinoma from 2004 to 2021. Exclusion criteria consisted of patients who lacked follow-up, received radiation, or underwent local tumor excision. Multinominal logistic regression was used to estimate the effect of patient and tumor characteristics on COD after diagnosis.

Results/Outcomes: Of the 291,915 patients diagnosed with colon cancer, 150,478 (52%) died. Within this cohort, 49% were male, 59% >70 years old, and 79% white. The breakdown by COD was as follows: 58% colorectal cancer, 20% cardiopulmonary disease, 14% other cause, 4% other cancer, 2% end stage organ disease, 1% accidental injury/homicide, 1% COVID-19, and 0.2% suicide. Over time, the percentage of patients dying from colorectal cancer has slowly declined from as high as 71% in 2006 to as low as 46% in 2020 (Figure 1). After stratification by stage, the most common COD for localized cancer was cardiopulmonary disease (40%) followed by another cause (28%), while colorectal cancer was the most prevalent COD for regional (53%) and distant disease (89%) followed by cardiopulmonary disease (22% and 3%, respectively). If patients died from colorectal cancer, they were most likely to die within 5 years of diagnosis, but after 5 years the most common COD was cardiopulmonary disease. COVID-19 contributed to 7% of colon cancer patient deaths in 2020 and 2021 with a predisposition for those diagnosed with an early-staged cancer. In the multinomial model, patients with localized tumors, who underwent surgery, did not receive chemotherapy, and were further out from their initial diagnosis were more likely to die from causes other than colorectal cancer.

Conclusion/Discussion: Colorectal cancer remains the primary COD in colon cancer patients with an advanced tumor, while cardiopulmonary disease is the leading COD for early-staged survivors. Over time, the number of deaths due to colorectal cancer have declined, which likely reflects earlier screening and advancements in treatment. However, COVID-19 was responsible for a notable proportion of deaths in colon cancer survivors since 2020. Overall, patients with localized colon cancer who are further out from their diagnosis tend to die from non-cancer causes. This highlights the importance of proactively managing patients’ co-morbidities after their cancer diagnosis and treatment, as it may significantly benefit their long-term survival.