Journal of Gastrointestinal Cancer最新文献

{"title":"Survival Benefits of Neoadjuvant Immunochemotherapy Versus Chemotherapy in Locally Advanced Esophageal Squamous Cell Carcinoma: A Propensity Matched Score.","authors":"Binwen Xu, Chengcheng Zhang, Tao Luo, Yue Zhang, Liwen Zhang, Guidong Shi, Maoyong Fu","doi":"10.1007/s12029-025-01293-x","DOIUrl":"https://doi.org/10.1007/s12029-025-01293-x","url":null,"abstract":"<p><strong>Background: </strong>While neoadjuvant chemotherapy (NCT) and neoadjuvant immunochemotherapy (NICT) are effective treatments for locally advanced esophageal squamous cell carcinoma (ESCC), comparative analyses of their long-term survival outcomes are scarce. This study aims to evaluate the treatment efficacy, safety, and survival outcomes between NICT and NCT.</p><p><strong>Methods: </strong>This retrospective study included 157 patients with locally advanced ESCC who underwent NCT or NICT followed by surgery at our hospital. To minimize confounding factors, PSM at a 1:1 ratio was conducted.</p><p><strong>Results: </strong>After PSM, a total of 51 matched pairs of ESCC patients receiving NICT and NCT were included for analysis. The median follow-up was 48.6 months (95% CI, 39.14-58.07). The NICT group showed significantly better overall survival (OS) and disease-free survival (DFS) than the NCT group (3-year OS: 78% vs 57%, P = 0.029; 3-year DFS: 68% vs 43%, P = 0.005). The NICT group achieved significantly higher partial response (PR) rates (78.4% vs 56.9%, P = 0.019) and pathological complete response (pCR) rates (27.5% vs 5.9%, P = 0.013) compared to the NCT group. No significant difference was observed in the overall incidence of treatment-related adverse events and postoperative complications between the two groups. Patients who achieved tumor remission, downstaging, or pCR experienced significantly longer OS and DFS (P < 0.05).</p><p><strong>Conclusion: </strong>For ESCC, NICT may offer a more sensitive treatment response and higher pathological remission rates than NCT, without increasing the risk of treatment-related adverse events or postoperative complications, indicating superior safety, efficacy, and long-term survival advantages.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"167"},"PeriodicalIF":1.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening Uptake and Diagnostic Yield of One-time Fecal Immunochemical Testing Vs One-time Colonoscopy for Colorectal Cancer: a Systematic Review and Meta-analysis.","authors":"Reechashree Dhungana, Naveen Gautam, Prabin Duwadee, Kamal Ranabhat, Bishal Paudel, Sunil Shrestha","doi":"10.1007/s12029-025-01286-w","DOIUrl":"10.1007/s12029-025-01286-w","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide. In recent years, its incidence has been increasing among younger populations. Screening methods such as colonoscopy and fecal immunochemical testing (FIT) are widely used to detect colorectal neoplasms. This systematic review and meta-analysis compare the screening uptake and diagnostic yield of one-time FIT versus a one-time colonoscopy for detecting CRC, non-advanced adenomas, and advanced adenomas.</p><p><strong>Methods: </strong>Databases (including MEDLINE, EMBASE, and CENTRAL) were searched for studies published up to November 1, 2024, that directly compared FIT and colonoscopy for CRC screening. Cochrane's Risk of Bias tool (RoB 2.0) was used for quality assessment. Risk ratios (RR) for screening uptake and odds ratios (OR) for diagnostic yield were calculated using an intention-to-screen analysis with a random-effects model. Heterogeneity was assessed using I² statistics.</p><p><strong>Results: </strong>Eleven randomized controlled trials (RCTs) with 207,347 participants were included. The intention-to-screen analysis showed a significantly higher screening uptake for one-time FIT compared to one-time colonoscopy (RR = 1.68; 95% CI, 1.43-1.99; P < 0.01). FIT had an inferior diagnostic yield for non-advanced (OR = 0.18; 95% CI, 0.13-0.24; P < 0.01) and advanced adenomas (OR = 0.47; 95% CI, 0.36-0.61; P < 0.01). No significant differences were observed between the two methods in detecting CRC (OR = 0.77; 95% CI, 0.48-1.25; P = 0.29).</p><p><strong>Conclusions: </strong>A one-time FIT results in higher screening uptake and comparable CRC detection compared to one time colonoscopy, but it has a lower diagnostic yield for both non-advanced and advanced adenomas. Since this analysis focuses on a single FIT test, further studies are needed to determine whether annual or biennial FIT screening compensates for its lower diagnostic yield over time.</p><p><strong>Trial registration: </strong>PROSPERO CRD 42024606884.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"166"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality Trends of Co-occurring Cirrhosis and Hepatocellular Carcinoma in the USA, 1999-2022: A Nationally Representative Sample.","authors":"Yousaf Zafar, Areesha Hafeez, Shanzay Akhtar, Hafsa Azam, Muzamil Akhtar, Nikki Duong","doi":"10.1007/s12029-025-01292-y","DOIUrl":"https://doi.org/10.1007/s12029-025-01292-y","url":null,"abstract":"<p><strong>Objective: </strong>Cirrhosis, caused by chronic liver diseases, leads to impaired liver function and increases the risk of hepatocellular carcinoma (HCC). This study analyzed CDC WONDER data to examine US patients where both cirrhosis and HCC were listed as co-occurring causes of death.</p><p><strong>Methods: </strong>Mortality records (1999-2022) were queried for deaths where both HCC (ICD-10 = C22.0) and cirrhosis (ICD-10 = K70.3, K74.5, K74.6) were listed among multiple causes of death in adults aged 25 + . Joinpoint regression analysis assessed annual percentage change (APC) in mortality trends. Age-adjusted mortality rates (AAMR) were analyzed across demographics.</p><p><strong>Results: </strong>From 1999 to 2022, cirrhosis and HCC caused 63,484 deaths. AAMR increased from 0.68 (1999) to 1.58 (2022). Mortality rose in three phases: initial increase (1999-2006, APC = 2.13; 95% CI = 0.07-3.28), rapid surge (2006-2017, APC = 5.57; 95% CI = 5.14-6.51), and gradual rise (2017-2022, APC = 1.78; 95% CI = 0.43-2.75). AAMR was consistently higher in men (2022 = men 2.60, women 0.66). Hispanics had the highest AAMR (2022 = 2.98), followed by Non-Hispanic (NH) Black (2022 = 1.48) and NH White (2022 = 1.36). Regional variation showed the highest AAMR in the West (AAMR 2022 = 2.10) and the lowest in the Northeast (AAMR 2022 = 1.06). During the 2021-2022 period, Oregon had the highest AAMR (3.21), while West Virginia had the lowest (0.73).</p><p><strong>Conclusion: </strong>The steady rise in co-occurring HCC and cirrhosis mortality underscores disparities across sex, race, and region. Targeted public health interventions are necessary to reduce these inequalities and curb mortality trends.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"165"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Analysis of Native Hawaiians and Other Pacific Islanders with Early Onset Colorectal Cancer.","authors":"Manasawee Tanariyakul, Chalothorn Wannaphut, Toshiaki Takahashi, Ryon Nakasone, Jared Acoba","doi":"10.1007/s12029-025-01278-w","DOIUrl":"10.1007/s12029-025-01278-w","url":null,"abstract":"<p><strong>Purpose: </strong>Rates of early-onset colorectal cancers (EOCRC) are increasing in Hawaii across all racial groups. Previous studies have shown that Native Hawaiians have a higher mortality rate compared to other racial groups; however, these studies only performed limited adjustments for sociodemographic factors. Our objective is to conduct a comprehensive analysis of outcomes among patients with EOCRC in a racially diverse population accounting for tumor factors and patient sociodemographics.</p><p><strong>Method: </strong>Data were abstracted for patients under the age of 50 years diagnosed with colorectal cancer between 2000 and 2022 in Hawaii. Overall survival of Asians, Whites, and Native Hawaiian or Other Pacific Islanders (NHOPI) was calculated using the Kaplan-Meier method. Two Cox proportional hazards regression models were created to assess predictors of survival: a minimally adjusted model (age, sex, stage, and race) and a fully adjusted model (also included insurance status, pathology grade, and tumor location).</p><p><strong>Results: </strong>A total of 379 patients were included in the final analysis (54.6% Asian, 19.8% White, 25.6% NHOPI). NHOPI patients more often had Medicaid or were uninsured (p < 0.001) and their cancers had a higher histopathology grade compared to White and Asian groups (p = 0.022). In the unadjusted Cox regression model, NHOPI race (Hazard ratio [HR] 2.005, 95% confidence interval [CI] = 1.231-3.265, p = 0.005), having Medicaid or being uninsured (HR 1.865, 95% CI = 1.331-2.612, p < 0.001), grade and stage were prognostic for survival. However, after adjusting for confounders, having Medicaid or being uninsured, grade, and stage remained prognostic factors, but race was not significantly associated with survival in both minimally and fully adjusted model (HR 1.534, 95% CI = 0.931-2.528, p = 0.093) (HR 1.138, 95% CI = 0.682-1.900, p = 0.757).</p><p><strong>Conclusion: </strong>This study concludes that while NHOPI patients with EOCRC demonstrated poorer survival compared to other racial groups, this disparity was largely explained by the large percentage of Medicaid and uninsured NHOPI patients. Additionally, the significantly higher histopathology grade in NHOPI explained the worsening survival. This study emphasizes the importance of addressing disparities in treatment access and utilization to improve outcomes. Further study is also needed to understand the mechanism underlying the higher tumor grade among NHOPI.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"164"},"PeriodicalIF":1.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Impact of Limberg Flap Reconstruction Following Abdominoperineal Resection: A Randomized Controlled Trial.\"","authors":"Mina Alvandipour, Sohrab Sayyadi, Nasibeh Samarghandi, Asal Khodabakhsh, Atousa Mortazavi Milani, Mohammad Javad Najafi","doi":"10.1007/s12029-025-01289-7","DOIUrl":"https://doi.org/10.1007/s12029-025-01289-7","url":null,"abstract":"<p><strong>Background: </strong>Perineal wound complications after abdominoperineal resection (APR) for low rectal cancer remain a significant challenge. Effective reconstruction methods are critical to reducing morbidity and improving outcomes.</p><p><strong>Objective: </strong>To compare the effectiveness of primary closure versus Limberg flap reconstruction in managing perineal defects post-abdominoperineal resection.</p><p><strong>Methods: </strong>Sixty patients undergoing APR for rectal cancer were randomized into two groups. Fifty-four patients completed the study and were analyzed (26 in the primary closure group and 28 in the Limberg flap group). Baseline characteristics, including mean age, gender distribution, cancer stage, and neoadjuvant chemoradiation status, were recorded. Primary outcomes included uncomplicated wound healing, while secondary outcomes assessed complications, wound healing time, and hospital stay. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>The average age of the participants was 68.04 ± 11.50 years, with an average weight of 74.42 ± 12.47 kg and a mean Body Mass Index (BMI) of 27.31 ± 3.90 kg/m². Males comprised 57.4% of the sample, 38.9% of whom had diabetes, and nearly 80% underwent neoadjuvant chemoradiation therapy. The Limberg flap group exhibited significantly lower complication rates (17.9% compared to 42.3%, p = 0.02), reduced wound healing times (6.14 ± 2.07 days compared to 8.12 ± 4.01 days, p = 0.03), and shorter hospitalization durations (7.68 ± 2.96 days compared to 11.35 ± 6.27 days, p = 0.008). Among diabetic patients in the primary closure cohort, there are significant differences in the rates of complications, infections, and wound dehiscence (p < 0.02, p < 0.02, p < 0.01, respectively).</p><p><strong>Conclusion: </strong>Limberg flap reconstruction offers superior outcomes compared to primary closure for perineal reconstruction following APR.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"163"},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locoregional Therapies for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus.","authors":"Ramanpreet Singh, Mina S Makary","doi":"10.1007/s12029-025-01280-2","DOIUrl":"10.1007/s12029-025-01280-2","url":null,"abstract":"<p><p>Portal vein tumor thrombus (PVTT) develops in up to half of patients with hepatocellular carcinoma (HCC) and historically signifies advanced-stage disease with limited treatment options and poor prognosis. Systemic therapy has been the standard treatment for HCC with PVTT, but this review highlights the potential of image-guided locoregional therapies including transarterial chemoembolization (TACE), transarterial embolization (TAE) radioembolization (TARE), hepatic arterial infusion chemotherapy (HAIC), and ablative or radiotherapeutic approaches to improve outcomes in this challenging context. We will summarize current evidence and clinical experience demonstrating that these modalities can achieve meaningful tumor control and extend survival, especially when tailored to tumor burden and PVTT extent or combined with systemic treatments. These findings underscore that aggressive locoregional treatment can be a valuable component of multidisciplinary management for advanced HCC, offering select patients an improved prognosis despite PVTT.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"162"},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Conversion Surgery vs Conventional Systemic Therapy in Stage IV Gastric Cancer: A Systematic Review and Meta-Analysis.","authors":"Kai Siang Chan, Liyang Xiao, Aung Myint Oo","doi":"10.1007/s12029-025-01265-1","DOIUrl":"10.1007/s12029-025-01265-1","url":null,"abstract":"<p><strong>Purpose: </strong>The overall prognosis of stage IV gastric cancer (GC) is poor. Large-scale and high-quality evidence on the role of conversion surgery (CS) is limited. This study aims to compare the long-term survival and morbidity in stage IV GC between systemic treatment followed by CS vs systemic treatment only (i.e. no CS).</p><p><strong>Methods: </strong>A systematic search was performed on PubMed, Embase, Scopus, and Cochrane Library till September 2024. The inclusion criteria were patients with stage IV GC who received systemic chemotherapy + / - immunotherapy/other adjunct therapies. Pooled hazard ratio was calculated to compare survival between CS and no CS, and various subgroup analyses were performed.</p><p><strong>Results: </strong>There were 36 studies with 3177 patients (CS n = 1273, no CS = 1904) included, consisting of 29 retrospective cohort studies, 6 prospective non-randomized trials, and 1 retrospective case series. The most commonly used chemotherapy regimen (n = 10 studies) was S-1 + cisplatin. The median OS range was 14.4-60.0 months and 4.7-19.9 months in the CS and no CS groups, respectively. Pooled OS (n = 2826 patients, HR 0.36, 95% CI: 0.32-0.40) and PFS (n = 609 patients, HR 0.38, 95% CI: 0.31-0.46) were superior in CS compared to no CS. Overall incidence of anastomotic leak, intra-abdominal abscess, and post-operative bleeding following CS were 5.4%, 3.6%, and 2.0%, respectively.</p><p><strong>Conclusion: </strong>Survival in patients with stage IV GC is superior with CS following systemic treatment compared to systemic treatment alone, but however, quality of evidence is low considering the predominant inclusion of retrospective studies and heterogeneous selection criteria for CS which may favour those with good tumour biology.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"161"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate-Specific Membrane Antigen Expression in Colorectal Cancer and Its Potential Implication in Disease Monitoring in Rectal Cancer.","authors":"Eundong Park, Xin Wang, Michel Kmeid, Noureldien Darwish, Clifton G Fulmer, Nusret Bekir Subasi, Marcello P Toscano, Jing Zhou, Haiyan Qiu, Maciej Gracz, Xulang Zhang, Hwajeong Lee","doi":"10.1007/s12029-025-01277-x","DOIUrl":"https://doi.org/10.1007/s12029-025-01277-x","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate-specific membrane antigen (PSMA) is expressed in tumor-associated vessels of diverse malignancies, such as colorectal cancer (CRC). PSMA-targeted approaches show promise for diagnosing, treating, and assessing therapy response in non-prostatic cancer. Disease monitoring following neoadjuvant chemoradiation (CRT) is especially important in rectal cancer.</p><p><strong>Methods: </strong>Firstly, clinical and histologic features of untreated CRC (n = 237; 54 from rectum) were examined for their association with PSMA expression. Secondly, rectal cancer cases following neoadjuvant CRT (n = 45) were retrieved to assess the relationship between PSMA expression, downstaging, and tumor volume reduction and were compared with untreated rectal cancers (n = 54).</p><p><strong>Results: </strong>In untreated CRC, PSMA expression was negatively associated with pTNM stage, pT stage, pN stage, tumor deposit presence and count, and post-op adjuvant therapy administration. Higher PSMA expression was correlated with shorter overall survival when pTNM stage was controlled. In the treated rectal cancer group, advanced pTNM stage was associated with a reduced PSMA expression. In addition, treated rectal cancers showed lower PSMA expression than untreated rectal cancers. While PSMA levels correlated with tumor volume reduction and downstaging following CRT, this association was lost in stage-matched analysis.</p><p><strong>Conclusion: </strong>PSMA expression was lower in more advanced CRCs, and the trend persisted in treated rectal cancer. After adjusting for pTNM stage, higher PSMA expression was predictive of reduced overall survival. Post-CRT PSMA level was associated with downstaging and pathologic tumor volume reduction in rectal cancer. Further studies are needed to assess the clinical value of PSMA-directed approaches in CRC management.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"159"},"PeriodicalIF":1.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statins and the Risk of Pancreatic Cancer.","authors":"Kuan-Fu Liao, Shih-Wei Lai","doi":"10.1007/s12029-025-01285-x","DOIUrl":"https://doi.org/10.1007/s12029-025-01285-x","url":null,"abstract":"","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"158"},"PeriodicalIF":1.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Analysis of Factors Associated with Treatment Delays in Asian, Native Hawaiian, and Other Pacific Islander Patients with Colorectal Cancer.","authors":"Manasawee Tanariyakul, Chalothorn Wannaphut, Toshiaki Takahashi, Edward Nguyen, Jared Acoba","doi":"10.1007/s12029-025-01279-9","DOIUrl":"10.1007/s12029-025-01279-9","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer (CRC) is the second most common cause of cancer death in the USA. Many modifiable factors affect prognosis, including but not limited to diet, smoking, alcohol, and time of diagnosis to initial treatment (TTT). Studies have found that patients who had a delay in surgery of greater than one month during the COVID pandemic and a TTT of greater than 31 days were at increased risk of death. The purpose of this study is to uncover the factors associated with treatment delay (surgery, systemic therapy, or radiation therapy) in patients with CRC.</p><p><strong>Method: </strong>We analyzed data from patients diagnosed with CRC between 2000 and 2022 at Queen's Medical Center in Honolulu, Hawaii. Patients initiating treatment ≥ 31 days after diagnosis were categorized as having a delayed treatment. Binary logistic regressions were used to identify predictors, adjusting for clinical and pathological factors.</p><p><strong>Result: </strong>A total of 3192 patients were analyzed. 1128 (35.3%) patients experienced delayed treatment. On multivariable analysis, patients with older age demonstrated a progressively increased odds of delayed treatment, with odds ratio (OR) ranging from 1.35 (95% CI 1.02-1.79; p = 0.039) for patients aged 50-59 years to 1.81 (95% CI 1.32-2.47; p < 0.001) for those aged ≥ 80 years compared with patients under 50 years. Patients with Medicaid or being uninsured had significantly higher odds of delayed treatment compared with patients with private insurance (OR 1.54, 95% CI 1.25-1.89; p < 0.001). Stages 2 and 3 CRC were associated with lower odds of delay compared with stage 1. Tumor location was associated with delayed treatment. Compared with right-sided tumors, patients with rectal tumors (OR 3.16, 95% CI 2.56-3.90; p < 0.001) and left-sided colon cancer were significantly more likely to experience delayed treatment (OR 1.40, 95% CI 1.15-1.71; p < 0.001). Gender, race, and histopathology grading were not significantly associated with TTT ≥ 31 days.</p><p><strong>Conclusion: </strong>Older age, having Medicaid or being uninsured, and having a rectal or left-sided tumor location were associated with delayed initiation of treatment in patients with colorectal cancer. Further research is needed to explore the underlying reasons for treatment delays in patients with these specific characteristics. Specific interventions, such as improving insurance access or addressing logistical challenges, may reduce time to initial treatment.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"160"},"PeriodicalIF":1.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}