Evidence map›Paper›PMID 42276596›Full record

ArticleBJS open2026

Association between age and surgical resection for patients with stage II or III colorectal cancer: national study.

Adil Rashid, Helen Blake, Lu Han, Jan van der Meulen, Michael S Braun, Nicola S Fearnhead, Kate Walker

Abstract read
In one paragraph

Article in BJS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Adil RashidDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.ORCID 0000-0003-2371-093X
Helen BlakeDepartment of Applied Health Research, University College London, London, UK.
Lu HanDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Jan van der MeulenDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Michael S BraunDepartment of Oncology, The Christie NHS Foundation Trust, School of Medical Sciences, University of Manchester, Manchester, UK.ORCID 0000-0002-6666-4868
Nicola S FearnheadDepartment of Colorectal Surgery, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK.
Kate WalkerDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.ORCID 0000-0001-5392-6323

Funding

NHSWelsh Government
6 · The paper itself

Abstract

introductionElderly patients with colorectal cancer (CRC) are less likely to undergo surgical resection. This study investigated the association between age and surgical resection, stratified by Eastern Cooperative Oncology Group performance status (PS), co-morbidities, tumour site, and mode of presentation.

methodsUsing national data from 2017-2022, patients diagnosed with stage II-III CRC in the English National Health Service were identified. The primary outcome was receipt of surgical resection. Risk-adjusted rates of surgical resection by age were estimated using multilevel multivariable logistic regression, testing for interactions with PS, co-morbidities, tumour site, and mode of presentation. Between-hospital variation in rates of surgical resection was also examined.

resultsOverall, 63 698 of 79 763 patients (79.9%) underwent surgical resection during the study period. PS substantially modified the relationship between age and surgery. After risk adjustment, approximately 90% of fit patients (PS 0 or 1) underwent surgery up to age 75 years, with a steep decline by age 90 years to 61.8% (95% confidence interval (c.i.) 58.3% to 65.3%) and 48.8% (95% c.i. 45.9% to 51.7%) for PS 0 and 1, respectively. For patients too unfit to work (PS ≥ 2), the adjusted rate of surgery was lower and declined earlier, from around 80% at age 60 years, and then more gradually to 25.7% (95% c.i. 23.5% to 27.8%) at age 90 years. After adjustment, between-hospital variation was larger in patients aged > 75 years than in younger patients (interquartile range 60.7-74.7% versus 84.9-90.7%, respectively).

conclusionIn patients fit enough to work, age is not associated with surgical decision-making until around age 75 years. In less fit patients, age is a key factor in decision-making across all ages. Substantial variation in rates of surgery between hospitals highlights the need for evidence-based guidelines to support equitable access to potentially curative treatment.

Indexed as

Colorectal NeoplasmsAgedAged, 80 and overAge FactorsColorectal Surgical ProceduresComorbidityFemaleHumansMaleMiddle AgedNeoplasm Stagingcolorectal resectionfrailtyperformance status

Identifiers

PMID42276596
PMCPMC13255999

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.