Colorectal cancer in young patients: Presentation, clinicopathological characteristics and outcome

ABSTRACT

Previous studies have emphasized the increasing incidence of colorectal cancer [CCR] among young adults and suggest that they may have more aggressive disease and worse five-year survivals than their older counterparts. Describe the profile of sporadic colorectal cancer in young patients focusing on its prevalence, clinicopathological characteristics, prognostic and survival factors. Three hundred and twenty-five CCR patients were divided in two groups Gl < 45 years and G2 > 45 years. 13.2% of patients were less than 45 years old. A family history of a first-degree relative with colorectal cancer was more frequent in young patients 44.1% vs 18.2% [p - 0.025]. A significant delay in seeking medical care was noted in Gl patients 29.7 weeks vs 18.6 weeks [p = 0.01]. A trend to have more aggressive stages III and IV at presentation was observed among young patients 55.8% vs 48.6% [p = 0.8]. Mucin-producing tumors were more frequently observed in Gl group 41.9% vs 12% [p = 0.000]. Mean survival was 76.9 months in Gl group and 91.7 months in G2 group [p = NS]. Five-year survival was 52% in Gl group and 58% in G2 group [p - 0.6]. Stage for stage comparison was not significant in determining survival. The only independent factors were delay in consultation, right location of the tumor, peritoneal carcinomatosis, and the need for chemotherapy. This study confirms that colorectal cancer in young patients is frequent. Despite more frequent occurrence of mucin-producing tumors, age is not by itself a worse outcome predictor