This retrospective, population-based cross-sectional study used the Texas Cancer Registry (2004–2019) to evaluate treatment delays (>6 weeks from diagnosis to definitive therapy), survival outcomes, and factors associated with delays in 12,079 patients with early age-onset colorectal cancer (EOCRC; diagnosed <50 years) versus 100,593 with average age-onset CRC (AOCRC; ≥50 years).
EOCRC patients had better overall survival than AOCRC (median OS not reached vs. 80 months; HR 0.56, 95% CI 0.56–0.60), but treatment delays independently worsened survival in EOCRC (HR 1.35, 95% CI 1.32–1.38). Language barriers were the key modifiable factor tied to treatment delay in EOCRC (OR 1.45, 95% CI 1.18–1.79). Higher Social Vulnerability Index also predicted worse OS (HR 1.22, 95% CI 1.19–1.26).
- Cross-sectional design limits causal inference; reasons for delay are not fully characterized. - Single-state registry (Texas) may limit generalizability to other regions. - Full text under embargo; granular variables (e.g., insurance type, specific language spoken) could not be verified beyond the abstract.
Screen EOCRC patients for language barriers early and connect them with interpreter services or patient navigators to reduce treatment delays, which independently worsen survival. Clinicians should also be alert to social vulnerability as a compounding risk factor for poor outcomes in this younger patient group.
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