Colorectal cancer in the young: a 12-year review of patients 30 years or less

Colorectal Dis. 2004 May;6(3):191-4. doi: 10.1111/j.1463-1318.2004.00596.x.

Abstract

Objectives: As the incidence of young colorectal cancer is rising, a review of the characteristics of such malignancy in those under 30 years of age is timely at this stage.

Patients and methods: Thirty-nine patients (21 M, 18 F) were operated upon over a 12-year period in a single centre. The mean age was 25 years and median follow-up was 20 months.

Results: Rectal bleeding, change in bowel habit and abdominal pain were the commonest symptoms. Six patients had a positive family history, while four others were diagnosed as index cases of familial adenomatous polyposis. Rectal tumours made up 43% of all colorectal cancers diagnosed. Seventy percent of patients presented at an advanced stage, but curative resection was attempted for 29 patients. Eight underwent palliative resections, 1 had an ileostomy while another underwent a bypass procedure. Eleven patients have died, 14 had no evidence of recurrent disease while 3 were still alive with recurrent disease.

Conclusion: Age does not affect survival, and early endoscopy is recommended for all with persistent symptoms. Early diagnosis, radical resection and adjuvant therapy still form the cornerstone in management of colorectal cancer in this age group.

MeSH terms

  • Abdominal Pain / etiology
  • Adolescent
  • Adult
  • Age Factors
  • Cohort Studies
  • Colorectal Neoplasms / complications*
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / therapy
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Humans
  • Male
  • Prognosis
  • Rectum
  • Retrospective Studies
  • Singapore
  • Survival Analysis