Colorectal cancer in patients under 50 years of age: A retrospective analysis of two institutions' experience

Table 1 Comparison of previously published reports of young patients with colorectal cancer

Ref.	Patients with CRC	Interval (yr)	Patient age (yr)	With family history of CRC (%)1
Recalde et al[6]	40	19	< 36	NR
Sanfelippo et al[7]	118	12	< 40	NR
Simstein et al[8]	41	15	< 40	4 (10)
Safford et al[9]	1203	33	< 41	6 (5)
Pitluk et al[10]	31	10	< 40	1 (3)
Behbehani et al[11]	473	11	< 40	NR
Adloff et al[12]	32	7	< 40	NR
Domergue et al[13]	782	18	< 41	NR
Palmer et al[14]	1052	12	< 40	NR
Fante et al[15]	902	9	< 51	18 (20)
Present series	180	16	< 50	20 (12)3

¹Degree of relation not otherwise specified;

²Series includes patients with familial adenomatous polyposis and/or ulcerative colitis;

³Patients with first degree relatives with colorectal cancer. NR: Not reported; CRC: Colorectal cancer.

Table 2 Patients’ presenting signs and symptoms of colorectal cancer n (%)

Clinical presentation	Patients
Rectal bleeding	99 (57)
Anemia	19 (11)
Abdominal pain	54 (31)
Rectal pain	7 (4)
Change in bowel habits	37 (21)
Weight loss	20 (11)
Bowel obstruction	16 (9)
Perforation	5 (3)
Perforated diverticulitis	1 (0.6)
Screening	5 (3)
Unknown	7 (4)

Table 3 Location of cancers n (%)

Anatomic location of cancer2	Cancers
Right colon1	31 (17.2)
Transverse colon	13 (7.2)
Descending colon	17 (9.4)
Descending and sigmoid colon junction	2 (1.1)
Sigmoid colon	29 (16.1)
Rectosigmoid colon	19 (10.6)
Rectum	71 (39.4)

¹Right colon includes cecum, ascending, hepatic flexure;

²Two patients had synchronous cancers.

Table 4 Colorectal cancer staging n (%)

Present series	Value	SEER2	Value
Age < 50 yr
Stage 11	37 (21)	Localized	30%
Stage 2	47 (26)	Regional	40%
Stage 3	70 (39)	Distant	27%
Stage 4	26 (14)	Unstaged	3%
Age ≥ 50 yr
Stage 1	88 (22)	Localized	38%
Stage 2	143 (36)	Regional	37%
Stage 3	135 (34)	Distant	19%
Stage 4	26 (7)	Unstaged	6%

¹Two patients had Stage 0 disease and one patient had Tis disease following polypectomy;

²Surveillance Epidemiology and End Results (SEER) 18, 2000-2009 stage distribution. Localized (confined to primary site), regional (spread to regional lymph nodes), distant (cancer has metastasized).

Table 5 Type of colon resection n (%)

Operation	Patients	Laparoscopic
Right colectomy	34 (19.8)	17 (50)
Transverse colectomy	2 (1.2)	2 (100)
Left colectomy	20 (11.6)	10 (50)
Descending and sigmoid colectomy	1 (0.6)	1 (100)
Sigmoid colectomy	22 (12.8)	15 (7)
Rectosigmoidectomy	24 (13.9)	21 (88)
Low anterior resection	40 (23.2)	26 (65)
Abdominoperineal resection	23 (13.4)	11 (48)
Subtotal/total colectomy	6 (3.5)	4 (67)
Total resections	172 (95.0)	107 (62)