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

• Published in: International journal of colorectal disease Vol. 29; no. 4; pp. 519 - 527
• Main Authors: de Sousa, João Batista, Souza, Caio Simões, Fernandes, Maria Bianca, de Castro Durães, Leonardo, de Almeida, Romulo Medeiros, dos Santos, Antônio Carlos Nóbrega, da Silva, Eduardo Freitas, de Oliveira, Paulo Gonçalves
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2014; Springer; Springer Nature B.V
• Subjects: Abdominal Pain - etiology; Adenocarcinoma - pathology; Adenocarcinoma - therapy; Adult; Age Factors; Aged; Cancer patients; Colorectal cancer; Colorectal Neoplasms - pathology; Colorectal Neoplasms - therapy; Delayed Diagnosis; Diagnosis; Female; Gastroenterology; Gastrointestinal diseases; Gastrointestinal Hemorrhage - etiology; Hepatology; Humans; Internal Medicine; Male; Medical colleges; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Original Article; Proctology; Prognosis; Risk Factors; Surgery; Weight Loss; Young patients; TNM staging; Colorectal cancer in young patients; Clinical presentation; Diagnosis; Colorectal cancer
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-013-1824-4

Purpose 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. Methods 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. Results 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. Conclusions Young patients with colorectal cancer had clinical and pathological presentation similar to that of older patients.