Clinicopathological Features of Colorectal Cancer Patients Under the Age of 50: Recent Experience and Case-Control Study of Prognosis in a Japanese Cohort

Nagai, Yoshinori; Hata, Keisuke; Kawai, Kazushige; Murono, Koji; Yasuda, Koji; Otani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Nozawa, Hiroaki; Yamaguchi, Hironori; Ishihara, Soichiro; Watanabe, Toshiaki

doi:10.1159/000446344

Cited by 13 publications

(23 citation statements)

References 23 publications

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“…This propensity of left-sided colon and rectal cancers in the younger population has been described in some other studies. [25][26][27] A recent study of 739 CRC patients < 50 years showed that most had tumors of left side (83%) compared to right side (17%). 28 Studies have also shown that the tumors of rectum and left-sided colon are associated with increased survival compared to right-sided CRC, which is the result of the different embryologic origin of these parts of the gut.…”

Section: Discussionmentioning

confidence: 99%

Rising Proportion of Young Individuals With Rectal and Colon Cancer

Kasi

Shahjehan

Cochuyt

et al. 2019

Clinical Colorectal Cancer

114

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We noticed an increased number of patients diagnosed with colorectal cancer (CRC) in their 20s, 30s, and 40s. We analyzed all CRC patients aged < 50 at our institutions from 1972 to 2017 and found increasing trends as well as a propensity for more distal location-findings that are hypothesis generating, given the embryologic origin of these tumors. This finding may have implications for screening guidelines. Background: Recent trends have identified increasing number of young individuals with rectal and colon cancers. These individuals, who are younger than 50 years old, in most instances would not meet screening guidelines. We aimed to report the characteristics and trend of the rising proportion of young individuals being diagnosed with rectal and colon cancers at our institutions. Patients and Methods: This study included 3381 rectal and colon cancer patients from the Mayo Clinic cancer registry from 1972 to 2017 who were diagnosed with rectal or colon cancer and who were < 50 years old. Patient and cancer characteristics are described. The Cochran-Armitage trend test was used to see if the change in percentage diagnosed at age < 50 years had a significant trend over the years. A linear regression model was fit to estimate the percentage change per year when the trend was approximately linear. Results: The percentage of patients diagnosed with rectal or colon cancer in different age categories over the years showed a rising trend for individuals aged < 50. Most of these tumors were distal (rectum, left-sided colon, and rightsided colon were 49.8%, 28.8%, and 21.4%, respectively). This was more so for patients < 50 diagnosed with rectal cancer, which showed a linear increase at a rate of 0.26% per year (P < .001). Conclusion: Our study affirms the rising proportion of colorectal cancers found in young individuals, with a linear ongoing rise of rectal cancers in particular. This may have implications for the current screening recommendations for colorectal cancers, which are already being revised.

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Section: Discussionmentioning

confidence: 99%

Rising Proportion of Young Individuals With Rectal and Colon Cancer

Kasi

Shahjehan

Cochuyt

et al. 2019

Clinical Colorectal Cancer

114

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“…The proportions of young-onset CRC in developing countries were noted to be higher than those in developed countries. (8)(9)(10)(11)16,18,19,22,23) This puzzling difference may be due to lifestyle and dietary patterns that individuals are exposed to during their childhood and younger adulthood years, which were different from those of preceding generations. (24) In other words, in historically low-risk regions for CRC, where rates in the older population have remained low, CRC incidence has increased significantly in newer generations.…”

Section: Discussionmentioning

confidence: 99%

“…The clinicopathological characteristics described in this study are in keeping with the current understanding of young-onset CRC, which usually presents with altered bowel habit and per-rectal bleeding. (9)(10)(11)14) The diagnostic challenge here is to distinguish benign causes of per-rectal bleeding from malignant causes. It is challenging for clinicians to thoroughly investigate per-rectal bleeding among young adults owing to cost constraints in public hospitals.…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological patterns and survival outcomes of colorectal cancer among young adults in Malaysia: an institutional cohort study

Wong¹,

Ling²,

Yeow³

et al. 2021

smedj

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Introduction: This study aimed to investigate the clinicopathological patterns and survival outcomes of young-onset colorectal cancer (CRC) in Malaysia. Methods: The study consisted of 206 patients with young-onset CRC (age < 50 years at diagnosis) and 1,921 patients with late-onset CRC (age ≥ 50 years at diagnosis) diagnosed during 2002–2016. The clinicopathological characteristics of patients with young-onset CRC were compared with those of patients with late-onset CRC during 2009–2013. Kaplan-Meier survival analysis was performed to determine the overall survival (OS) and disease-specific survival (DSS) in these patients. Results: The overall proportion of young-onset CRC was 10.7%. Mean age for young-onset CRC was 39.5 ± 7.4 years, with male-to-female ratio of 1.2:1.0. There were more Malay patients with young-onset CRC than late-onset CRC (44.0% vs. 19.9%, p = 0.004). Most CRC were diagnosed at advanced stage in both groups. However, young-onset CRC showed more aggressive tumour characteristics, such as poorer differentiation and mucinous subtype. Despite such differences, OS and DSS in both groups were similar (five-year OS for young-onset CRC vs. late-onset CRC: 44.2% vs. 49.0%, p = 0.40; five-year DSS for young-onset CRC vs. late-onset CRC: 48.8% vs. 57.6%, p = 0.53; mean survival of young-onset CRC vs. late-onset CRC: 4.9 years vs. 5.4 years, p = 0.15). Advanced stage at diagnosis and treatment modality were independent prognostic factors. Conclusion: The unique ethnic and histological differences between patients with young- and late-onset CRC suggest that young-onset CRC may represent a distinct entity. However, despite such differences, prognosis between both groups were equivalent.

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“…The proportion of rectal cancers is higher among adults under 50910 than in older adults. In the US, colorectal cancer is not only increasing among under 50s but presenting at later stages11; thus, the evidence suggests a real increase of aggressive disease arising at younger ages.…”

Section: Patterns Of Changementioning

confidence: 93%