ArticleResearch square2025
A tale of two tracts: Comparison of the survival rates of upper and lower GIT cancers by age, gender, and handgrip strength in geriatric population from 12 European countries.
Article in Research square, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Gastrointestinal tract (GIT) cancers are among the most prevalent malignancies worldwide. Due to variations in anatomical locations and biological behaviors of upper and lower GIT cancers, differences exist in their survival and physical capacity domains. Limited large-scale comparative datasets exist for upper and lower GIT cancers, particularly in the geriatric population. This study aimed to compare survival rates and handgrip strength (HGS) between upper and lower GIT cancer European geriatric patients, with specific attention to age and gender differences. Methods: This longitudinal cohort study used data about the European geriatric population from the Survey of Health, Ageing, and Retirement in Europe (SHARE) across waves 4 to 9. HGS was measured using a dynamometer. Regression analysis was performed using the survival methodology with a Weibull distribution adjusted for age, gender, and HGS. Results: A total of 33,379 adults aged ≥ 50 were included, comprising 106 participants with upper GIT cancer and 99 with lower GIT cancer. Overall, nine-year survival was 39.6% for upper GIT and 34.3% for lower GIT cancer patients. Lower GIT cancer was associated with significantly higher mortality risk (β = 0.579, p < 0.001). Female gender conferred a protective effect (β = -0.215, p < 0.001), with women showing notably better survival than men in the lower GIT group. Advanced age (≥ 80 years) significantly increased mortality risk (β = 1.105, p < 0.001). Higher HGS was associated with longer survival (β = -0.365, p < 0.001), particularly in upper GIT cancers. Conclusion: In this study, patients with lower GIT cancers had worse survival compared to upper GIT cancers, particularly among older men with low HGS. Women with lower GIT cancers had a survival advantage over men, while HGS had a stronger positive predictive value in upper GIT cancers. These distinctions call for personalized and targeted assessment and management plans for GIT cancers.
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