Younger Colon Cancer Patients Receive More Chemotherapy But No Greater Survival Benefit Interview with:
Kangmin Zhu, PhD, MD

John P. Murtha Cancer Center, Walter Reed National Military Medical Center
Professor at the Uniformed Services University of the Health Sciences in the
Department of Preventive Medicine and Biostatistics
Bethesda, Maryland What is the background for this study?

Response: An article published on JAMA Surgery in 2015 showed more utilization of chemotherapy among young colon cancer patients.  To demonstrate the study findings, we analyzed the data from the Department of Defense healthcare system, in which all members have the same level of access to medical care and therefore the potential effects of insurance status and types on research results can be reduced. What are the main findings?

Response: The main findings were that young and middle-aged colon cancer patients were 2 to 8 times more likely to receive postoperative chemotherapy and 2.5 times more likely to receive multiagent regimens, compared with their counterparts aged 65 to 75 years.  However, no matched survival benefits were observed for the young and middle-aged among patients who received surgery and postoperative chemotherapy. What should readers take away from your report?

Response: Whether younger patients with colon cancer are overtreated with chemotherapy is an emerging topic in research.

Our study shows that young and middle-aged colon cancer patients were more likely to receive postoperative chemotherapy and multiagent chemotherapy compared to older patients.  However, no additional survival benefits were found among younger patients who received surgery and postoperative chemotherapy.  While our study suggests the possibility of overuse of chemotherapy among younger colon cancer patients, more research is warranted. What recommendations do you have for future research as a result of this study?

Response: Since all-cause death was used as the outcome of our study, future research is warranted by using colon cancer-specific death as the outcome.  Moreover, further endeavors are needed to improve the completeness and quality of routine medical records data for research on the topic or evaluate their potential effects on research results. 

No disclosures Thank you for your contribution to the community.


Manjelievskaia J, Brown D, McGlynn KA, Anderson W, Shriver CD, Zhu K. Chemotherapy use and survival among young and middle-aged patients with colon cancer. JAMA Surg. 2017 Jan 25. doi: 10.1001/jamasurg.2016.5050 [Epub ahead of print]

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on January 25, 2017 by Marie Benz MD FAAD