Journal of Surgery

Do younger patients with colorectal cancer presents with more advanced disease at initial presentation?

Abstract

M. Shadab Khan*, Asma Sarfaraz, Ramna Nadeem, Bushra Shirazi and Abdaal Waseem Khan

Introduction: Colorectal cancer the second most lethal malignancy widely considered a disease that affects people after the 4th decade of life but an interesting change in trend is observed and it was found that colorectal cancer rate has been increasing in young patients living under their 4th decade. These patients even present with more advanced diseases and generally have a poor overall prognosis compared to the older patients.

Materials and methods: Colorectal cancer patients presented in Sindh Institute of urology and transplantation’s Oncology center from January 2011 till December 2020 were reviewed retrospectively. For data analysis, all patients were divided into two groups, Group A young age population (age between 18-50 years) Group B old age population (age 51 years and onward).

Subgroup analysis of the study period (from January 2011 – December 2015 first period while from January 2016 – December 2020 second period) was performed to check the progressive change in the trend of stage and clinical characteristics of colorectal cancer in young and old patients. Details were reviewed from the patient’s files and all data was collected as per the Proforma requirement. Collected data was analyzed for results using SPSS version 23.0.

Results: Total of 612 patients with colorectal cancer presented between 2011 till 2020. Among these patients 243 (39.7%) presented between January 2011 till December 2015. Patients age 50 years and younger were 410 (66.8%).

Results showed a statistically significant association between patient age and tumor characteristics (histopathology and tumor differentiation). When data was analyzed over different study periods results showed that there is a statistically significant association between tumor differentiation and patient age. A change in the trend of clinical stage of the tumor with respect to patient age over this period of time was also noted.

Conclusion: The development and implementation of screening protocols and awareness programs will definitely have an impact to control disease incidence, patient prognosis, and survival outcome.

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