Abstract
Background. Early onset colorectal carcinoma (CRC) is rare and has been hypothesized to be a biologically and clinically distinct entity personifying aggressive disease and worse survival. Methods. Data for 131 patients was collected by retrospective chart review. Cox proportional hazard model was used to compute prevalence ratios and 95% confidence intervals. Results. Early onset sporadic CRC accounted for 32% of all CRC treated in the specified time period. The mean age was 33.3 ± 7.9 years and the male to female ratio was 2 : 1. Colon and rectal cancers accounted for 55% and 45% of patients, respectively. 96% of rectal carcinoma patients received appropriate therapy as opposed to 65% of colon cancers. On multivariable analysis, appropriate reception of therapy (PR 4.99; 95% CI, 1.21–20.6) and signet ring morphology (PR 2.40; 95% CI, 1.33–4.32) were significantly associated with rectal cancers as opposed to colon cancer. Kaplan-Meier analysis revealed a trend towards inferior survival for rectal carcinoma 2 years after diagnosis. Conclusion.A high prevalence of early onset CRC was noted in the study. A trend towards inferior survival was seen in patients with rectal cancer. This finding raises the possibility of rectal carcinoma being an aggressive subset of young CRC.
Highlights
Colorectal carcinoma (CRC) is one of the most common cancers diagnosed worldwide
We conclude that a high incidence of early onset CRC is noted in our study population of which almost half had rectal disease
This group had a higher prevalence of poor prognostic factors and showed a trend towards inferior prognosis 2 years after diagnosis despite the fact that a larger proportion of these patients had completed appropriate therapy
Summary
Colorectal carcinoma (CRC) is one of the most common cancers diagnosed worldwide. It has been documented that CRC is the second most common malignancy in females and the third most common amongst males [1]. The risk of colon cancer is 1 in 10 males after the 8th decade of life [3]. The life time risk of sporadic CRC is 5% and it accounts for 90% of the cases diagnosed in patients above 50 years [3]. Colon and rectal cancers accounted for 55% and 45% of patients, respectively. 96% of rectal carcinoma patients received appropriate therapy as opposed to 65% of colon cancers. Kaplan-Meier analysis revealed a trend towards inferior survival for rectal carcinoma 2 years after diagnosis. A trend towards inferior survival was seen in patients with rectal cancer. This finding raises the possibility of rectal carcinoma being an aggressive subset of young CRC
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