Abstract
to evaluate the clinical characteristics of patients with colorectal cancer under the age of 50 treated at a public hospital in Brasilia over 5 years. we conducted a longitudinal, retrospective study, with 184 patients undergoing surgical procedures at the Asa Norte Regional Hospital (HRAN), including those who underwent only biopsy, between January 2013 and January 2018. We divided the patients into two groups: under the age of 50 (n=39) and age equal to or greater than 50 years (n=145). We compared the groups as to age, sex, symptoms, time between symptom onset and diagnosis, family and personal history, tumor location, histopathological characteristics, applied surgical management, staging and mortality. the group of patients under the age of 50 had more individuals with stage III and IV (p=0.041), more frequent poorly differentiated tumors (10.25% versus 3.52%; p=0.153), and higher incidences of compromised surgical margins (p=0.368), angiolymphatic (p=0.07) and perineural (p=0.007) invasion, which denotes more advanced disease in this group of patients. the study showed the low effectiveness of population screening methods for colorectal cancer currently used in this population, given the high incidence of the disease and late diagnosis in both groups.
Highlights
The estimated incidence of colorectal cancer (CRC) is 1.36 million new cases per year worldwide[1]
We assessed the presence of the following comorbidities, such as Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM), and risk factors described for CRC, such as diagnosis of intestinal polyposis, inflammatory bowel diseases (IBD), lifestyle habits, such as smoking and alcohol consumption, family history of colorectal cancer in first-degree relatives, personal history of cancer, and obesity
There were no cases of familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC) diagnosed in the studied population
Summary
The estimated incidence of colorectal cancer (CRC) is 1.36 million new cases per year worldwide[1]. In Brazil, there were an estimated 36,360 new cases of colorectal cancer between 2018-2019, 17,380 in men and 18,980 in women These values correspond to a risk of 16.83 new cases for every 100,000 men and 17.90 for every 100,000 women. It is the third most common cancer in men and the second among women[2]. It is well established in the literature that the incidence of CRC increases significantly after the 5th decade of life and continues to increase with advancing age[3,4]. The recommended average age for starting screening is traditionally 50 years, more than 1/10 of cases of CRC (11% of colon tumors and 18% of rectal tumors) occur in individuals under 50, and the incidence and mortality have increased in this group[3,4,5,6,7,8]
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