Assessment #8
Date: October 30, 2020
Subject: Impact of age on the use of adjuvant treatments in patients undergoing surgery for colorectal cancer: patients with stage three colon or stage two or three rectal cancer
Citation: Sarasqueta, C et al. "Impact of age on the use of adjuvant treatments in patients undergoing surgery for colorectal cancer: patients with stage III colon or stage II/III rectal cancer." BMC cancer vol. 19,1 735. 25 Jul. 2019, doi:10.1186/s12885-019-5910-z
Assessment:
This article taught me more about age and its impact on surgeries in colorectal cancer patients with stage three colon cancer and those with phase two or three rectal cancer. By analyzing whether there are age differences in adjuvant chemotherapy and preoperative radiotherapy in patients with colorectal cancer, I hope to apply this to my original work project. By figuring out the typical age of treatment and the treatment type, I can gain more credibility with the app users and apply this in the design process.
The differences between ages in the use of chemotherapy in stage three colon cancer and stage preoperative radiotherapy for stage two and three of rectal cancer are as follows. The ages were separated into three groups: younger, sixty-five, and under; older, people between sixty-five and eighty years; and the oldest, people over eighty years of age. The researchers used a Generalized estimating equation through their method of analyzing the associations between age and the use of the treatments and adjusting for sociodemographic and clinical factors. The researchers were able to find the correlation between individuals from the same hospital.
One of the interesting facts I found is that less than thirty percent of each participant's age group had the screening done. I find this surprising that it is so little because it could have improved treatment options and outcomes. Although younger people were more likely to have undergone colon cancer screening, there was not a significant difference in rectal cancer. These results are astonishing because the youngest group of participants who had undergone screening was only about twenty-six percent in colon cancer and 13 percent in rectal cancer. Although screening increased in stage three types of cancers, I find it interesting that this is not considered in the use of earlier stages.
Likewise, this applies to assessing whether these differences remain after considering environmental, social, and health factors; Health behaviors such as alcohol intake and smoking habits, and a family history of cancer. Additionally, socioeconomic factors were considered, such as education and area of residency calculated using a method of Esnaola based on five census indicators related to occupation and educational attainment. The 2749 patients included in the study showed no significant differences found in the deprivation area, and that there were no notable age differences in tumor sights. The use of adjuvant chemotherapy for patients with colon cancer decreased significantly with age. Additionally, comorbidity, the simultaneous presence of two or more diseases or medical conditions in a patient, also contributed to the decreased use of this chemotherapy in colon cancer. Additionally, between the ages of Chemotherapies, a lower level of education in older patients does not contribute to the use of chemotherapy as treatment.
Compared to Rectal cancer, where sixty-one percent received radiotherapy before surgical intervention. After comparing the external factors, age remains the prime factor contributing to treatment; significantly dropping as age increases. They did find a correlation between comorbidities and a decrease in radiotherapy treatment.
Overall external variables had less of an effect as age. I would like to create an app that I can use to predict the time of screening patients should have and the external factors I can attribute to making the age more precise and a reminder to have the screening done.