Clinical Characteristics of Colorectal Cancer and Prognosis for Patients Younger Than 40 Years Old

ABSTRACT

BACKGROUND: Although the incidence of colorectal cancer in young adults is low, they seem to show advanced tumors with a poor prognosis at their initial presentation due to diagnostic delay. We evaluated colorectal cancer in young patients with respect to clinical characteristics and prognosis. METHODS: Twelve hundred and seventy-three colorectal cancer patients were evaluated retrospectively. Familial adenomatous polyposis and ulcerative colitis related cases were excluded. We grouped these patients into younger (40 years old) and older (>40 years old) patients. These two groups were compared with respect to sex, tumor location, duration of symptoms and signs, patterns of DNA ploidy, histological differentiations, TNM stage, survival rate, and familial tendency of colorectal cancer. RESULTS: One hundred forty-nine patients (11.7%) were 40 years old or younger. There was no significant difference between the two groups with respect to sex, tumor location, patterns of DNA ploidy, and 5-year survival rate. Histological patterns revealed a higher incidence of mucinous and signet-ring cell tumors in the younger group than in the older group (12.7% vs. 2.7% and 4.0% vs. 0.7%, p<0.05). The duration of the symptoms was shorter in the younger group, being less than 3 months in 56.3% of the younger group and 36.3% of the older group. Colorectal cancer in the younger group seemed to present more advanced lesions, especially those in stage III. Familial clustering of cancers(younger group, 25.5%; older group, 9.3%) and hereditary nonpolyposis colorectal cancer(younger group, 7.4%; older group, 0.7%) were more prevalent in the younger group. CONCLUSION:For colorectal cancer in younger patients with histological shortcomings and familial clustering, every effort is needed to make an earlier diagnosis.