Abstract
Introduction: Colorectal cancer in the Adolescent and Young Adult population are increasing and are characterized by a more advanced stage at diagnosis, poorer cell differentiation, higher signet ring histology, and left-sided colon location of the primary tumor. This study aims to compare colorectal cancer data in the Adolescent and Young Adult population-based on tumor location.Materials and Methods: This is a retrospective cross-sectional study of colorectal cancer in the Adolescent and Young Adult population from April 2017 to September 2020 in Shree Birendra Hospital. Data were collected for age, sex, clinical features, histology, TNM stage, colonoscopy finding, radiologic features, treatment, and follow-up status based on tumor location. Data were analyzed using Excel 2010 and SPSS v 17.Results: The total number of patients was 61 with the mean age of 32.36 ± 6.24 years. There was a male preponderance of 63.93%. Right-sided colorectal cancer was 24.59% while left-sided colorectal cancer was 75.41%. For right-sided colorectal cancers, the most common symptoms were pain abdomen (73.3%) and diarrhea (53.3%) while for left-sided colorectal cancers, it was pain abdomen (80.4%) and bleeding per rectum (45.7%). The most common histology was adenocarcinoma (95.08%) with moderately differentiated being most common in both locations. Surgery, radiation and chemotherapy for right-sided and left-sided colorectal cancer were 86.66%, 0.0%, 86.66% and 58.67%, 28.26%, 89.13% respectively.Conclusions: Left-sided colorectal cancer was more common in the Adolescent and Young Adult population in our study. There were signifi cant differences in the clinical presentation of colorectal cancer as per the tumor location.
Highlights
Colorectal cancer in the Adolescent and Young Adult population are increasing and are characterized by a more advanced stage at diagnosis, poorer cell differentiation, higher signet ring histology, and left-sided colon location of the primary tumor
The prognosis of the Colorectal cancer (CRC) is similar when matched for the stage of disease at presentation the survival is lower for the youngest subgroups.[8]
This study aims to compare colorectal cancer in the AYA population-based on tumor location and describe age & sex distribution, clinical features, histology, TNM stage, radiologic features, treatment, and follow-up status based on tumor location
Summary
Colorectal cancer in the Adolescent and Young Adult population are increasing and are characterized by a more advanced stage at diagnosis, poorer cell differentiation, higher signet ring histology, and left-sided colon location of the primary tumor. The surge in CRC incidence in young adults is alarming as the overall CRC frequency has been decreasing.[5] CRC in the AYA population are characterized by a more advanced stage at diagnosis, poorer cell differentiation, higher prevalence of signet ring cell histology, and left-sided colon location of the primary tumor.[5] Young patients with colorectal cancer have several distinct clinic-pathological and molecular biological features.[6] Though initial signs and symptoms of CRC are similar in pediatric and adult patients, the strikingly higher frequency of mucinous histology suggests that the biology of CRC differs in pediatric and adult patients and may contribute to poor outcomes.[7] CRC in young adults presents more frequently with stage 3 or 4 diseases, underscoring its relevance in this population. The prognosis of the CRC is similar when matched for the stage of disease at presentation the survival is lower for the youngest subgroups.[8]
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