Association between prediagnostic risk factors and survival after colorectal cancer diagnosis in Golesten cohort study.

This study investigated the survival rates of colorectal cancer (CRC) and the association between several pre-diagnostic factors, including demographic, anthropometric, behavioral, nutritional, lifestyle, and medical history and CRC incidence and survival. Among 50,045 participants in the Golestan cohort study, 190 patients diagnosed with CRC during the follow-up period were included in this study. Cox regression and Kaplan-Meier were used for analysis. The CRC incidence risk was significantly higher in males (HR = 2.20; 1.54-3.14), adults aged 50-70 years (HR = 1.86, 1.36-2.55), adults aged 70 years and older (HR = 3.71; 2.13-6.44), and urban dwellers (HR = 1.74; 1.22-2.47). The 1-year, 2-year, and 5-year overall survival was 60.3%, 47.5%, and 35.2%, respectively. Higher pre-diagnostic socio-economic status (SES) was associated with a significantly decreased mortality (HR = 0.55; 0.34-0.89). While, age 70 years and older (HR = 2.79; 1.12-6.99), pre-diagnostic opium use (HR = 2.35; 1.36-4.07), and metastasis (HR = 2.97; 1.97-4.48) were associated with a significantly increased mortality. Health policies should be implemented to enhance healthcare services and screening programs in low-SES areas. The general population, especially males and adults aged 50 years and older should be informed about CRC screening, CRC symptoms, and healthy lifestyles and diets. Furthermore, there is a critical need to raise awareness about the harmful effects of opium on CRC.