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Rectal cancer in the young: analysis of contributing factors and surgical outcomes

  
@article{JGO29089,
	author = {Odinaka Mogor and Agnes Ewongwo and Ogaga Ojameruaye and Viraj Pandit and Pamela Omesiete and Carolina Martinez and Paul Hsu and Aaron Scott and Emad Elquza and Valentine Nfonsam},
	title = {Rectal cancer in the young: analysis of contributing factors and surgical outcomes},
	journal = {Journal of Gastrointestinal Oncology},
	volume = {10},
	number = {5},
	year = {2019},
	keywords = {},
	abstract = {Background: Rectal cancer (RC) among young patients (≤50 years) is on the rise. The factors associated with development of RC are established however; factors leading to early RC remain unclear. The aim of this study was to assess factors associated with RC among young patients
Methods: National estimates for patients with RC were abstracted from the National Inpatient Sample (NIS) database [2010–2012]. Patients were divided into two groups: young (≤50 years) and old (>50 years). Demographic, comorbidities, procedures performed, and hospital outcomes were collected. Regression analysis was performed to compare both groups.
Results: A total of 68,699 patients with RC were included. Incidence of RC among young patients increased significantly over the study period (2.4% vs. 3.4%; P=0.04). Majority of young patients with RC were white females. Bleeding was the most common presentation among young patients (P=0.03). Younger patients were more likely to have a family history of RC (P=0.01) and were more likely to undergo elective surgery (P=0.04) and laparoscopic surgery (P=0.02) compared to the older patients. Younger patients with RC were also more likely to use alcohol (P=0.03), be obese (P=0.02) compared to elder patients. There was no difference in the other co-morbidities between the two groups. After controlling for all factors in a regression model, younger patients had a lower complication rate (P=0.01), hospital LOS (P=0.02), and mortality rate (P=0.04).
Conclusions: RC in younger patients appears as a different disease with different outcomes. There appears to be multifactorial and environmental factors contributing to this trend. Race and gender also play a role in the incidence of RC in the young. Identifying these risk factors will lead to a more robust intervention plan to help improve care among younger patients with RC.},
	issn = {2219-679X},	url = {http://jgo.amegroups.com/article/view/29089}
}