Treatment delay significantly increases mortality in colorectal cancer: a meta-analysis

Delaying the initiation of cancer treatment increases the risk of mortality, particularly in colorectal cancer (CRC), which is among the most common and deadliest malignancies. This study aims to explore the impact of treatment delays on mortality in CRC. A systematic literature search was conducted...

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Bibliographic Details
Published in:GeroScience Vol. 47; no. 3; pp. 5337 - 5353
Main Authors: Ungvari, Zoltan, Fekete, Mónika, Fekete, János Tibor, Lehoczki, Andrea, Buda, Annamaria, Munkácsy, Gyöngyi, Varga, Péter, Ungvari, Anna, Győrffy, Balázs
Format: Journal Article
Language:English
Published: Cham Springer International Publishing 01.06.2025
Springer Nature B.V
Subjects:
Analysis
Biomedical and Life Sciences
Cancer
Cancer therapies
Cell Biology
Chemotherapy
Clinical medicine
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - mortality
Colorectal Neoplasms - therapy
Complex patients
Decision making
Estimates
Geriatrics/Gerontology
Health care policy
Humans
Life Sciences
Malignancy
Medical treatment
Meta-analysis
Molecular Medicine
Mortality
Oncology
Original
Original Article
Patients
Radiation therapy
Ratios
Risk
Statistical analysis
Statistical significance
Statistics
Surgery
Survival
Time Factors
Time-to-Treatment - statistics & numerical data
Treatment Delay
Cancer treatment access
Colorectal cancer
Referral pathways
Multimorbidity
Time-to-treatment benchmarks
Treatment delay
Healthcare disparities
Telemedicine
Diagnostic delays
Cancer survival
Healthcare inefficiencies
Frailty
Oncology care pathways
Patient navigation
Geriatric oncology
ISSN:2509-2723, 2509-2715, 2509-2723
Online Access:Get full text
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Summary:Delaying the initiation of cancer treatment increases the risk of mortality, particularly in colorectal cancer (CRC), which is among the most common and deadliest malignancies. This study aims to explore the impact of treatment delays on mortality in CRC. A systematic literature search was conducted in PubMed, Web of Science, and Scopus for studies published between 2000 and 2025. Meta-analyses were performed using random-effects models with inverse variance method to calculate hazard ratios (HRs) for both overall and cancer-specific survival at 4-, 8-, and 12-week treatment delay intervals, with heterogeneity assessed through I 2 -statistics and publication bias evaluated using funnel plots and Egger’s test. A total of 20 relevant studies were included in the meta-analysis. The analyses of all patients demonstrated a progressively increasing risk of 12–39% with longer treatment delays (4 weeks, HR = 1.12; 95% CI, 1.08–1.16; 8 weeks, HR = 1.24; 95% CI, 1.16–1.34; 12 weeks, HR = 1.39; 95% CI, 1.25–1.55). In particular, incrementally higher hazard ratios were observed for all–cause mortality at 4 weeks (HR = 1.14; 95% CI, 1.09–1.18), 8 weeks (HR = 1.29; 95% CI, 1.20–1.39), and 12 weeks (HR = 1.47; 95% CI, 1.31–1.64). In contrast, cancer-specific survival analysis showed a similar trend but did not reach statistical significance (4 weeks, HR = 1.07; 95% CI, 0.98–1.18; 8 weeks, HR = 1.15; 95% CI, 0.95–1.39; 12 weeks, HR = 1.23; 95% CI, 0.93–1.63). Treatment delays in colorectal cancer patients were associated with progressively worsening overall survival, with each 4-week delay increment leading to a substantially higher mortality risk. This study suggests that timely treatment initiation should be prioritized in clinical practice, as these efforts can lead to substantial improvements in survival rates.
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ISSN:2509-2723
2509-2715
2509-2723
DOI:10.1007/s11357-025-01648-z