Colorectal Cancer in Patients Under 40 Years of Age

Abstract

Objective: To identify the presentation and outcome of patients under 40 years of age compared to those over 40.

Design: Retrospective, descriptive study.

Setting: Department of Surgery, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University.

Subjects: All patients who underwent colorectal cancer surgery between January 1993 and December 1997.

Data collection: By a review of medical records, endoscopic notes, radiographic reports, operative notes and pathological reports.

Measurement: Descriptive statistic, c²- test and the Kaplan-Meier survival techniques.

Results: Patients under 40 years old constituted ~10% (13) of the 136 patients operated on for primary colorectal cancer. Common presentations in both groups were: a change in bowel habits, detection of anemia or an abdominal mass, and loss of weight. However, the incidence of abdominal masses in Groups Y (age < 40 years) was significantly higher than Group O (age ³ 40 years). The proportion of Dike’s Stage A, B, C and D lesions in Group Y was 15.4%, 15.4%, 38.5% and 30.8% respectively versus 4.9%, 28.5%, 35.8% and 30.9% in Group O. The incidence of mucinous/signet ring cell and poor grade tumors was 15.4% and 15.4%, respectively, in Group Y and 1.6% and 8.1% in Group O. The overall 5.years survival rate were 28.1% in Group Y and 30.4% in Group O.

Conclusions: This study revealed no difference in the presenting symptoms nor the stage at presentation though tumor characteristics and survival of the younger adults looked poorer than the older group, difference were not statistically significant.