Clinicopathological features and survival of early-onset colon cancer: a SEER-based analysis of 156,031 curative-intent surgical patients

Faruk Recep Özalp; Özge Yetginoğlu; Şerife Sivridemir; Erkut Demirciler; Oktay Halit Aktepe; Hüseyin Salih Semiz; Aziz Karaoğlu

Clinicopathological features and survival of early-onset colon cancer: a SEER-based analysis of 156,031 curative-intent surgical patients

Abstract

Aims: To analyze the clinicopathological features and survival outcomes of early-onset colon cancer (EOCC, <50 years) compared with late-onset colon cancer (LOCC, ≥50 years) in a large curative-intent surgical cohort. Methods: We retrospectively analyzed 156,031 stage I-III colon cancer patients from the SEER database (2010-2015 and 2018-2022) who underwent therapeutic surgical resection. Patients with stage 0/IV, appendiceal tumors, or unknown staging were excluded. Clinicopathological characteristics and cause-specific survival (CSS) were compared. Multivariable Cox proportional hazards regression was performed to identify independent prognostic factors. Results: EOCC accounted for 9.0% (n=14,028) of the curative surgical population. The proportion of EOCC significantly increased from 8.4% in 2010 to 11.6% in 2022 (p<0.001 for trend). EOCC patients were more likely to present with stage III disease (45.2% vs. 33.8%), distal tumor location (57.5% vs. 37.2%), and higher perineural invasion (12.9% vs. 8.9%) (p<0.001 for all). Despite advanced presentation, EOCC demonstrated superior 5-year CSS (88.1% vs. 81.4%, log-rank p<0.001). After multivariable adjustment, EOCC was associated with a 42.3% lower risk of cancer-specific death (HR: 0.577; 95% CI: 0.548-0.608; p<0.001). Conclusion: In this curative-intent surgical cohort, the proportion of EOCC increased over time. Although EOCC was associated with more advanced stage and adverse pathological features, younger age remained associated with better CSS after multivariable adjustment.

Keywords

Supporting Institution

None.

Ethical Statement

This study was conducted in accordance with the ethical standards of the Declaration of Helsinki. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, a publicly available, de-identified database. Because no identifiable patient information was accessed and no direct patient contact was involved, this study was exempt from Institutional Review Board (IRB) review and informed consent was not required.

Thanks

None.

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Details

Primary Language

English

Subjects

Clinical Oncology

Journal Section

Research Article

Authors

Faruk Recep Özalp ^*
0000-0002-2863-3243
Türkiye

Özge Yetginoğlu
0000-0002-0684-8710
Türkiye

Şerife Sivridemir
0000-0002-4766-220X
Türkiye

Erkut Demirciler
0000-0001-9747-3784
Türkiye

Oktay Halit Aktepe
0000-0003-3540-0701
Türkiye

Hüseyin Salih Semiz
0000-0002-7083-8517
Türkiye

Aziz Karaoğlu
0000-0001-5500-156X
Türkiye

Publication Date

August 15, 2026

Submission Date

June 12, 2026

Acceptance Date

July 12, 2026

Published in Issue

Year 2026 Volume: 7 Number: 4

IZ

https://izlik.org/JA39DJ82GA

Cite

RIS / Bibtex

APA

Özalp, F. R., Yetginoğlu, Ö., Sivridemir, Ş., Demirciler, E., Aktepe, O. H., Semiz, H. S., & Karaoğlu, A. (2026). Clinicopathological features and survival of early-onset colon cancer: a SEER-based analysis of 156,031 curative-intent surgical patients. Journal of Medicine and Palliative Care, 7(4), 764-771. https://izlik.org/JA39DJ82GA

AMA

1.Özalp FR, Yetginoğlu Ö, Sivridemir Ş, et al. Clinicopathological features and survival of early-onset colon cancer: a SEER-based analysis of 156,031 curative-intent surgical patients. J Med Palliat Care / JOMPAC / jompac. 2026;7(4):764-771. https://izlik.org/JA39DJ82GA

Chicago

Özalp, Faruk Recep, Özge Yetginoğlu, Şerife Sivridemir, et al. 2026. “Clinicopathological Features and Survival of Early-Onset Colon Cancer: A SEER-Based Analysis of 156,031 Curative-Intent Surgical Patients”. Journal of Medicine and Palliative Care 7 (4): 764-71. https://izlik.org/JA39DJ82GA.

EndNote

Özalp FR, Yetginoğlu Ö, Sivridemir Ş, Demirciler E, Aktepe OH, Semiz HS, Karaoğlu A (August 1, 2026) Clinicopathological features and survival of early-onset colon cancer: a SEER-based analysis of 156,031 curative-intent surgical patients. Journal of Medicine and Palliative Care 7 4 764–771.

IEEE

[1]F. R. Özalp et al., “Clinicopathological features and survival of early-onset colon cancer: a SEER-based analysis of 156,031 curative-intent surgical patients”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 4, pp. 764–771, Aug. 2026, [Online]. Available: https://izlik.org/JA39DJ82GA

ISNAD

Özalp, Faruk Recep - Yetginoğlu, Özge - Sivridemir, Şerife - Demirciler, Erkut - Aktepe, Oktay Halit - Semiz, Hüseyin Salih - Karaoğlu, Aziz. “Clinicopathological Features and Survival of Early-Onset Colon Cancer: A SEER-Based Analysis of 156,031 Curative-Intent Surgical Patients”. Journal of Medicine and Palliative Care 7/4 (August 1, 2026): 764-771. https://izlik.org/JA39DJ82GA.

JAMA

1.Özalp FR, Yetginoğlu Ö, Sivridemir Ş, Demirciler E, Aktepe OH, Semiz HS, Karaoğlu A. Clinicopathological features and survival of early-onset colon cancer: a SEER-based analysis of 156,031 curative-intent surgical patients. J Med Palliat Care / JOMPAC / jompac. 2026;7:764–771.

MLA

Özalp, Faruk Recep, et al. “Clinicopathological Features and Survival of Early-Onset Colon Cancer: A SEER-Based Analysis of 156,031 Curative-Intent Surgical Patients”. Journal of Medicine and Palliative Care, vol. 7, no. 4, Aug. 2026, pp. 764-71, https://izlik.org/JA39DJ82GA.

Vancouver

1.Faruk Recep Özalp, Özge Yetginoğlu, Şerife Sivridemir, Erkut Demirciler, Oktay Halit Aktepe, Hüseyin Salih Semiz, Aziz Karaoğlu. Clinicopathological features and survival of early-onset colon cancer: a SEER-based analysis of 156,031 curative-intent surgical patients. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Aug. 1;7(4):764-71. Available from: https://izlik.org/JA39DJ82GA