Early symptom patterns among young Medicaid-insured individuals with colorectal cancer: A population-based analysis.

24 Background: Survey and anecdotal data from patients with early-onset colorectal cancer (EOCRC) suggest that they are more likely to have symptoms ignored or to see multiple providers prior to diagnosis compared to older patients. We aimed to assess this trend in a population-based study. Methods: We conducted a population-based cohort study from the Ohio Cancer Incidence Surveillance System linked to Ohio Medicaid claims. We included individuals aged 18-65 and diagnosed with CRC between January 2017 and December 2020 with at least 1 year of continuous enrollment. We selected age-matched cancer-free controls from the same population using 5:1 nearest neighbor Mahalanobis distance matching without replacement. We assessed symptoms based on ICD-10 codes documented in claims data at monthly intervals in the year pre-diagnosis, including CRC-related (anemia, abdominal pain and gastrointestinal (GI) bleeding) and “control” (hypertension and musculoskeletal pain) symptoms. We calculated rate ratios (RRs) as the monthly rate of symptom claims among CRC patients divided by the rate in controls, stratified by age group (