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Am J Surg. 2013 Mar;205(3):312-6; discussion 316. doi: 10.1016/j.amjsurg.2012.10.016.

Colorectal cancer: are the "young" being overlooked?

Author information

  • 1Department of Surgery, Level 2, DePaul Building, Providence Hospital and Medical Centers, 16001 West Nine Mile Road, Southfield, MI, USA. deepatags@hotmail.com

Abstract

BACKGROUND:

Colorectal cancer (CRC) is increasing in young patients. We aimed to assess the trends of CRC and its corresponding clinical presentation in the young.

METHODS:

Cancer registry patients were divided into 3 groups according to age:<50, 50-75, and >75 years. Charts were reviewed for average-risk patients <50 years of age to assess clinicopathological data.

RESULTS:

We identified 3,599 patients between 1982 and 2010. Patients aged <50 years increased from 6.8% in (1982-1990) to 8.5% in (2000-2010) with a decrease in the 50-75-year age group from 45.5% to 43.4% (P = .03). One hundred eighty-eight patients were <50 years of age at the time of diagnosis. None had screening tests. Eighty-four percent had symptoms including rectal bleeding (76.5%), abdominal pain (58%), and an altered bowel pattern (71%). Twenty-one percent had symptoms for >6 months before diagnosis. Forty percent had stage III and 20% stage IV disease. This is unlike the 50-75-year age group in which the majority of patients had stage I disease.

CONCLUSIONS:

Young CRC patients are mostly symptomatic. Advanced disease at presentation could be caused by a delay in investigating these patients. Colonoscopy should be offered early to young patients presenting with warning symptoms.

Copyright © 2013 Elsevier Inc. All rights reserved.

PMID:
23414955
[PubMed - indexed for MEDLINE]
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