Skip to main content
2026 ASCRS Annual Scientific Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
CME
CME
Invitation/Ticketed Event
Invitation/Ticketed Event
Invited Lectureship
Invited Lectureship
Award Recipient
Award Recipient
Live Streamed Session
Live Streamed Session
Nurses Contact Hours
Nurses Contact Hours
Self-Assessment
Self-Assessment
Live Q&A and Polling
Live Q&A and Polling
Social
Social
Industry
Industry

Session:: ePosters-Mon1015-M6: Colon & Colorectal Cancer

EP837 - Rates of Guideline-Concordant Treatment of Early Onset Colon Cancer in Texas

Monday, May 11, 2026
10:58 AM - 11:03 AM ET

    ePoster Presenter(s)

  • KH

    Krystle Henderson, MD

    General Surgery Resident
    Dell Medical School at The University of Texas at Austin
    Austin, Texas, United States

    Disclosure information not submitted.

    • Author(s)

  • KW

    Katherine E. Walsh, MD (she/her/hers)

    General Surgery Resident
    Dell Medical School at The University of Texas at Austin
    Dell Medical School at The University of Texas at Austin
    Austin, TX, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • YZ

    Yahan Zhang, MS

    Pharmacy Graduate Student
    Dell Medical School at The University of Texas at Austin
    Austin, Texas, United States

    Disclosure information not submitted.

  • HK

    Hyeun Ah Kang, Ph.D.

    Assistant Professor
    The University of Texas at Austin
    Austin, Texas, United States

    Disclosure information not submitted.

  • Srinivas Joga Ivatury, MD MHA

    Chief of Colon and Rectal Surgery
    University of Texas at Austin
    The University of Texas at Austin
    Austin, TX, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • CS

    Claire Sokas

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Katherine E. Walsh, MD: This individual has no financial relationships with ineligible companies.
Srinivas Joga Ivatury, MD MHA: This individual has no financial relationships with ineligible companies.
Claire Sokas: This individual has no financial relationships with ineligible companies.
Purpose/Background: Early onset colon cancer (EO-CC), age < 50, is a rising population and currently is treated in a system designed for traditional aged patients (age>50) with colon cancer. It is unknown if those with early onset colon cancer have the same level of guideline concordance of treatment compared to traditional aged patients. The treatment guidelines for non-metastatic colon cancer include receipt of surgery, lymph node examination, and receipt of chemotherapy for patients with pathology-confirmed node positive disease. We aim to evaluate the rate of guideline-concordant treatment of non-metastatic early onset colon cancer in Texas.

Methods/Interventions: We conducted a cross-sectional analysis of non-metastatic patients with early onset colon cancer (age < 50) using 2015-2019 Texas Cancer Registry (TCR) data. We evaluated our cohort for rates of guideline concordance. Specifically, we evaluated receipt of surgical resection, identification of 12 or more lymph nodes in the pathologic specimen, and receipt of adjuvant chemotherapy in patients with Stage 3 disease only. We examined the rate of guideline concordance and the reasons for guideline discordance in the entire cohort and stratified by stage. Guideline concordance was defined as patients who received surgery with examination of > 12 LNs for stages 1 and 2, with the addition of adjuvant chemotherapy for stage 3 EO-CC.

Results/Outcomes: In the study period, a total of 2,244 patients were included in the analysis (Stage 1: 454, Stage 2: 688, and Stage 3: 995). The mean age at diagnosis was 41 with 52% Caucasian. The overall rate of guideline concordance was 75.6% (Table 1). Stratified by stage, the guideline concordance rate was 56.2% for Stage 1, 89.1% for Stage 2, and 75.6% for Stage 3. Only 10 patients in the cohort did not receive surgery. There was inadequate lymph node identification in 15.8% of the cohort. There were 20.9% of the patients with stage 3 disease that did not receive adjuvant chemotherapy. Multivariate analysis found that increasing age (OR: 1.05, CI 1.04-1.07) and higher stage compared with stage 1 (Stage 2 OR: 5.65, CI 4.16-7.74), Stage 3: OR: 2.07, CI: 1.62-2.64) were associated with increased odds of guideline concordance.

Conclusion/Discussion: The rate of guideline-concordant treatment for in EO-CC in Texas is only 75.6%, and varies significantly by stage, leading to suboptimal treatment for a significant number of EO-CC patients.

Table 1
1Guideline concordant treatment definition: stage 1 and stage 2: >=12 lymph nodes examined; stage 3: >=12 lymph nodes examined and received chemotherapy. All patients (N= 2,137) had received surgery.