Document Type
Article
Presentation Date
5-9-2026
Abstract
BACKGROUND: A growing population of older adult cancer survivors faces competing cancer and noncancer health risks. There are limited real-world data on recurrence patterns beyond 5 years post-treatment.
METHODS: This was a SEER-Medicare retrospective cohort study of patients aged ≥66 with stage I-III breast, colon, or rectal cancer who received definitive surgery and survived ≥5 years from diagnosis without recurrence or second primary malignancy. Late recurrence (5-10 years postdiagnosis) was identified using a validated algorithm to detect treated recurrence in Medicare claims. Demographic and clinical characteristics collected at cancer diagnosis were assessed as predictors of late treated recurrence using restricted mean survival time (RMST) regression.
RESULTS: The sample included 12 859 breast, 17 329 colon, and 4427 rectal cancer survivors. The cumulative incidence of late treated recurrence 5-10 years postdiagnosis was 5.0% in breast, 4.4% in colon, and 8.0% in rectal cancer survivors. In all cohorts, stage was associated with shorter RMST. The absolute risk difference between stage I and III was greatest in breast (2% vs 18.1%), followed by rectal (5.2% vs 10.3%) and colon (2.7% vs 6.7%) cancer survivors (P < .001 for all cohorts). Although their effect on RMST was modest (< 5%), higher grade, node-positive, and ER-positive disease in breast, left-sided tumors in colon, and radiation in rectal cancer were associated with late treated recurrence. Across all cohorts, the incidence of other-cause mortality (24.1%-34.0%) exceeded cancer-specific mortality (2.9%-6.2%).
CONCLUSIONS: Late treated recurrence in older long-term survivors is uncommon, but risk remains elevated 5 years postdiagnosis in those with more advanced stage.
Recommended Citation
Yasin, Faiza; Westvold, Sarah J.; Long, Jessica B.; Hyslop, Terry; Cecchini, Michael; Leeds, Ira; Silber, Andrea; Wang, Shi-Yi; Spees, Lisa; Forman, Rebecca; Kwaramba, Tendai; Taylor, Melissa; Gross, Cary P.; and Dinan, Michaela A., "Risk of Late Recurrence of Colorectal and Breast Cancer Among Older Long-Term Cancer Survivors." (2026). Kimmel Cancer Center Papers, Presentations, and Grand Rounds. Paper 87.
https://jdc.jefferson.edu/kimmelgrandrounds/87
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Language
English
Comments
This article is the author's final published version in JNCI Cancer Spectrum, Volume 10, Issue 3, Article Number pkag002.
The published version is available at https://doi.org/10.1093/jncics/pkag002. Copyright © The Author(s) 2026. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.