To evaluate the association between time-to-treatment initiation (TTI) and 3-year metastasis risk among patients newly diagnosed with non-metastatic colorectal cancer (non-mCRC).
Approach:
Study Design: A cohort study using Optum’s Clinformatics Data Mart, focusing on patients aged 40 years or older with incident non-mCRC diagnosed between January 2017 and December 2021.
Cohort Selection: Included patients undergoing curative-intent surgery within 1 year of diagnosis, with specific eligibility criteria to ensure nonmetastatic status.
Data Collection: Diagnoses were identified using ICD-10-CM codes, and treatment initiation was tracked through insurance claims.
Analysis Method: A 2-stage, data-driven approach using extreme gradient boosted regression trees (XGBoost) with a Cox model to identify treatment-delay thresholds.
Key Findings:
Delays in treatment initiation are associated with an increased risk of metastasis within three years.
The study identifies specific thresholds for treatment delays that may impact metastatic risk.
Current guidelines do not adequately address acceptable treatment delays for non-mCRC.
Interpretation:
The study aims to identify specific thresholds for treatment delays in colorectal cancer to inform evidence-based benchmarks.
Limitations:
The study used a retrospective cohort design, which may limit causal inferences.
Findings may not be generalizable beyond the specific population studied.
Conclusion:
Identifying treatment-delay thresholds may provide insights into improving outcomes in colorectal cancer care.
