Do young patients have different clinical presentation of colorectal cancer causing delay in diagnosis?

Abstract

The incidence of colorectal cancer is increasing among young patients. In these patients, colorectal cancer is believed to have a poorer prognosis because it is more aggressive and diagnosed at later stages; however, the behavior of these tumors in young patients remains to be elucidated. We investigated the impact of time interval between onset of symptoms and diagnosis (TISD) at the pathologic stage of colorectal cancer in young patients. The medical records of 215 patients with colorectal adenocarcinoma were reviewed. Patients were divided into two groups according to age. The young group (age < 50 years) consisted of 66 patients, and the older group (age ≥ 50 years) of 149 patients. Clinical variables, TISD, pathologic stage, operative mortality, and oncologic outcomes were compared between groups. The older group had less abdominal pain (74.0 vs. 56.0 %, p = 0.0129). In multivariate analysis, the following variables were independently associated with tumor pathologic stage: personal history of inflammatory bowel disease (p < 0.0001), family history of familial adenomatous polyposis (p = 0.00100), and smoking (p = 0.0070). Both groups had similar rates regarding pathologic stage (I, 15 vs. 22 %; II, 22 vs. 24 %; III, 27 vs. 16 %; IV, 37 vs. 38 %, p = 0.3380). There was no difference in overall survival [45 (69 %) vs. 84 (61 %), p = 0.2482] and cancer-free survival [36 (63 %) vs. 83 (62 %), p = 0.9218] between groups. Young patients with colorectal cancer had clinical and pathological presentation similar to that of older patients.