Older Patients Fared Worse After Colorectal Cancer Surgery

Colorectal cancer patients who are older had more complications and higher death rate after surgery

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Though cancer presents a difficult road ahead for most people, new research suggests that older patients with colorectal cancer may face more challenges than younger patients.

This new study focused on patients who received surgical treatment for colorectal cancer, cancer of the bowel or rectum.

The researchers found that though overall rates of complications and deaths improved during the 10-year study period, patients over the age of 65 fared worse than their younger peers.

"Ask your doctor about screenings for colorectal cancer."

According to the authors of this study, which was led by Mehraneh D. Jafari, MD, of the University of California, Irvine School of Medicine, it is important to understand how cancer affects older patients, especially as the US population ages.

For this study, the researchers wanted to examine how older patients with colorectal cancer fared after surgery to treat the condition.

To do so, Dr. Jafari and team analyzed data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from January 1, 2001 to December 31, 2010. They identified 1,043,108 colorectal cancer patients over the age of 45 who had surgery to treat their condition.

The patients were divided into different groups based on their age, and instances of complications and deaths were noted.

The patients tended to be older — 63.8 percent were age 65 and older and 22.6 percent were age 80 and older.

The patients aged 80 and older were 1.7 times more likely to have to be urgently admitted to the hospital than patients below age 65.

Older patients were also more likely to stay in the hospital longer and have a higher hospital bill. Patients aged 80 and older had a hospital bill that was on average $9,492 higher than patients below the age 65, and their hospital stay was an average of 2.5 days longer.

During the 10 years of the study, the overall death rate of these colorectal cancer patients decreased by an average of 6.6 percent per year. The biggest decrease in death rates (9.1 percent) was seen in the oldest patients, those aged 85 or older. The overall number of surgeries for colon cancer also decreased during the study period by 5.1 percent per year.

Despite these improvements, older patients still had a higher risk of dying in the hospital and having complications than did patients under the age of 65, and this risk increased as age increased.

"Since most (63.8 percent) [colorectal cancer surgery] procedures in the United States are performed on patients 65 years and older, measures to improve outcomes need to be implemented in all settings," wrote Dr. Jafari and team.

This study did not include data on other treatment methods used beyond surgery, including chemotherapy, and did not include any information on the stage of the patients' cancer. Further research is needed to explore how age may affect these additional details.

This study was published online April 9 in JAMA. No conflicts of interest were reported.

Review Date: 
April 8, 2014
Last Updated:
April 10, 2014