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Sporadic Carcinoma of the Colon–Rectum in Young Patients: A Distinct Disease? A Critical Review

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Abstract

Introduction

Colon carcinoma is rare in patients under 40 years but incidence is increasing. Results regarding outcome of this age group have been controversial and difficult to interpret. Some authors have reported a worse prognosis related to advanced stage at diagnosis and cancer-aggressive behavior. We tried to assess whether sporadic colon carcinoma in young patients is a distinct disease with different etiology and how this reflects on outcome.

Methods

Most relevant papers published and indexed on PubMed in the last 20 years were reviewed. Epidemiological data were retrieved from the Surveillance, Epidemiology and End Results database and discussed.

Discussion

Stage-specific analyses adjusted for age have demonstrated that prognosis is related to tumor stage regardless of age. Advanced stage is partly due to tumor biology and to delayed diagnosis. Younger patients show a better performance status that allows aggressive multimodal treatment.

Conclusion

Colon carcinoma in young adults appears to be a distinct disease characterized by biological aggressiveness, but prognosis is not worse due to a better performance status at time of surgical intervention.

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References

  1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics 2002. CA Cancer J Clin. 2005;55:74–108. doi:10.3322/canjclin.55.2.74.

    Article  PubMed  Google Scholar 

  2. Yiu HY, Whittemore AS, Shibata A. Increasing colorectal cancer incidence rates in Japan. Int J Cancer. 2004;109(5):777–81. doi:10.1002/ijc.20030.

    Article  PubMed  CAS  Google Scholar 

  3. Haenszel W, Correa P. Cancer of the large intestine: epidemiologic findings. Dis Colon Rectum. 1973;16(5):371–7.

    Article  PubMed  CAS  Google Scholar 

  4. O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY. Rates of colon and rectal cancers are increasing in young adults. Am Surg. 2003;69:866–72.

    PubMed  Google Scholar 

  5. Surveillance, Epidemiology, and End Results (SEER) Program (2002) Public use data (1973–1999). Cancer Statistics Branch, Surveillance Research Program, DCCPS. http://www.seer.cancer.gov

  6. Johns LE, Houlston RS. A systematic review and meta-analysis of familial colorectal cancer risk. Am J Gastroenterol. 2001;96:2992.

    Article  PubMed  CAS  Google Scholar 

  7. Yang Z, Kang L, Wang L, **ang J, Cai G, Cui J, et al. Characteristics and long-term survival of colorectal cancer patients aged 44 years and younger. Clin Transl Oncol. 2012;14(12):896–904.

    Article  PubMed  Google Scholar 

  8. Dozois EJ, Boardman LA, Suwanthanma W, et al. Young-onset colorectal cancer in patients with no known genetic predisposition: can we increase early recognition and improve outcome? Med (Baltimore). 2008;87:259–63.

    Article  Google Scholar 

  9. Savas N, Dagli U, Akbulut S, Yuksel O, Sahin B. Colorectal cancer localization in young patients: should we expand the screening program? Dig Dis Sci. 2007;52(3):798–802.

    Article  PubMed  Google Scholar 

  10. Bulow S. Colorectal cancer in patients less than 40 yearsof age in Denmark 1943–1967. Dis Colon Rectum. 1982;25:209–14.

    Article  Google Scholar 

  11. O’Connell JB, Maggard MA, Livingston EH, et al. Colorectal cancer in the young. Am J Surg. 2004;187:343–8.

    Article  PubMed  Google Scholar 

  12. Liang JT, Huang KC, Cheng AL, et al. Clinicopathological and molecular biological features of colorectal cancer in patients less than 40 years of age. Br J Surg. 2003;90:205–14.

    Article  PubMed  CAS  Google Scholar 

  13. Kam MH, Eu KW, Barben CP, et al. Colorectal cancer in the young: a 12-year review of patients 30 years or less. Color Dis. 2004;6(3):191–4.

    Article  CAS  Google Scholar 

  14. Griffin PM, Liff JM, Greenberg RS, Clark WS. Adenocarcinomas of the colon and rectum in persons under 40 years old. A population-based study. Gastroenterology. 1991;100:1033–40.

    PubMed  CAS  Google Scholar 

  15. Marble K, Banerjee S, Greenwald L. Colorectal carcinoma in young patients. J Surg Oncol. 1992;51(3):179–82.

    Article  PubMed  CAS  Google Scholar 

  16. Mourra N, Zeitoun G, Buecher B, et al. High frequency of chromosome 14 deletion in early-onset colon cancer. Dis Colon Rectum. 2007;50:1881–6.

    Article  PubMed  Google Scholar 

  17. Liu B, Farrington SM, Petersen GM, Hamilton SR, Parsons R, Papadopoulos N, et al. Genetic instability occurs in the majority of young patients with colorectal cancer. Nat Med. 1995;1(4):348–52.

    Article  PubMed  CAS  Google Scholar 

  18. Rajiv VD, Michael PL, Philip BP. Genetic and phenotypic correlates of colorectal cancer in young patients. N Engl J Med. 2000;342:137–8.

    Article  Google Scholar 

  19. Messerini L, Vitelli F, De Vitis LR, et al. Microsatellite instability in sporadic mucinous colorectal carcinomas: relationship to clinicopathological variables. J Pathol. 1997;182:380–4.

    Article  PubMed  CAS  Google Scholar 

  20. O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY. Do young colon cancer patients have worse outcomes? World J Surg. 2004;28(6):558–62.

    Article  PubMed  Google Scholar 

  21. Chauvenet M, Cottet V, Lepage C, Jooste V, Faivre J, Bouvier AM. Trends in colorectal cancer incidence: a period and birth-cohort analysis in a well-defined French population. BMC Cancer. 2011;11:282.

    Article  PubMed  Google Scholar 

  22. Chiang JM, Yeh CY, Changchien CR, Chen JS, Tang R, Chen JR. Mucinous adenocarcinoma showing different clinicopathological and molecular characteristics in relation to different colorectal cancer subgroups. Int J Colorectal Dis. 2010;25:941–7.

    Article  PubMed  CAS  Google Scholar 

  23. Faivre J, Bedenne L, Boutron MC, Milan C, Collonges R, Arveux P. Epidemiological evidence for distinguishing subsites of colorectal cancer. J Epidemiol Community Health. 1989;43(4):356–61.

    Article  PubMed  CAS  Google Scholar 

  24. Johansen C, Mellemgaard A, Skov T, Kjaergaard J, Lynge E. Colorectal cancer in Denmark 1943–1988. Int J Colorectal Dis. 1993;8(1):42–7.

    Article  PubMed  CAS  Google Scholar 

  25. Schellerer VS, Merkel S, Schumann SC, Schlabrakowski A, Förtsch T, Schildberg C, et al. Despite aggressive histopathology survival is not impaired in young patients with colorectal cancer: CRC in patients under 50 years of age. Int J Colorectal Dis. 2012;27(1):71–9. Epub 2011 Sep 1.

    Article  PubMed  Google Scholar 

  26. Lin JT, Wang WS, Yen CC, Liu JH, Yang MH, Chao TC, et al. Outcome of colorectal carcinoma in patients under 40 years of age. J Gastroenterol Hepatol. 2005;20(6):900–5.

    Article  PubMed  Google Scholar 

  27. Wang L, Hollenbeak CS, Stewart DB. Node yield and node involvement in young colon cancer patients: is there a difference in cancer survival based on age? J Gastrointest Surg. 2010;14(9):1355–61. Epub 2010 Jun 29.

    Article  PubMed  Google Scholar 

  28. Hemminki K, Santi I, Weires M, Thomsen H, Sundquist J, Bermejo JL. Tumor location and patient characteristics of colon and rectal adenocarcinomas in relation to survival and TNM classes. BMC Cancer. 2010;10:688.

    Article  PubMed  Google Scholar 

  29. Endreseth BH, Romundstad P, Myrvold HE, et al. Rectal cancer in the young patient. Dis Colon Rectum. 2006;49:993–1001.

    Article  PubMed  Google Scholar 

  30. O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Ko CY. Are survival rates different for young and older patients with rectal cancer? Dis Colon Rectum. 2004;47(12):2064–9.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. General and Emergency Surgery, Department of Surgery, University of L’Aquila, 67100, L’Aquila, Italy

    Andrea Ciarrocchi & Gianfranco Amicucci

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  1. Andrea Ciarrocchi
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  2. Gianfranco Amicucci
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Correspondence to Andrea Ciarrocchi.

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Ciarrocchi, A., Amicucci, G. Sporadic Carcinoma of the Colon–Rectum in Young Patients: A Distinct Disease? A Critical Review. J Gastrointest Canc 44, 264–269 (2013). https://doi.org/10.1007/s12029-013-9507-5

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