Publication:

Colorectal cancer in younger adults (

Background Colorectal cancer (CRC) is a common cancer worldwide with significant geographical variation in its incidence. CRC among young adults is not well reported in Indian patients.

Methods A retrospective study was performed to determine the burden and to analyze the clinicopathological characteristics of newly diagnosed CRC among younger adults (<50 years). Chi-square method was used to analyze the clinicopathological characteristics. P≤0.05 was considered statistically significant.

Results CRC among younger adults comprised 40.3% of total patients median age of 40 years at diagnosis, was associated with predominantly male patients with male: female ratio of 1.8:1, positive family history, lesser co-morbidities (p=0.000), majority left sided primary tumor with left: right ratio of 4.6:1, more frequent high grade histology compared to older age group (p=0.000), advanced primary tumor and nodal metastasis. Approximately one third patients had distant metastasis at diagnosis compared to in one fourth patients in older patients. Peritoneal metastasis was significantly higher among younger adults compared to older patients (p=0.000). Significantly greater proportion of patients among younger adults initially presented with bowel obstruction (p=0.034), for which upfront emergency surgical procedures was performed in significantly higher proportion of patients compared to the older age group (p=0.007).

Conclusions Advanced stage and aggressive disease biology of CRC in younger adult warrants inclusion of one decade younger age group into present screening recommendation.