Premium
Colorectal cancer in younger adults from a Bi‐National Colorectal Cancer Audit registry
Author(s) -
Kong Joseph C.,
Su Wai Kin,
Ng Chu Woon,
Guerra Glen R.,
Chakraborty Joy,
Lutton Nicholas,
Morris Bradley,
Gourlas Peter
Publication year - 2021
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.16250
Subject(s) - medicine , colorectal cancer , odds ratio , cohort , incidence (geometry) , confidence interval , cancer , cancer registry , retrospective cohort study , physics , optics
Background The incidence of colorectal cancer (CRC) in younger adults (<50 years old) is rising worldwide, at a rate of 1% per annum since mid‐1980s. The clinical concern is that younger adults may have more advanced disease leading to poorer prognosis compared to their older cohort due to lack of screening. Therefore, the aim of this study is to assess the incidence and short‐term outcomes of colorectal cancer in younger adults. Methods This is a retrospective study from a prospectively maintained bi‐national database from 2007 to 2018. Results There were 1540 younger adults diagnosed with CRC, with a rise from 5.8% in 2007 to 8.4% in 2018. Majority had lower American Society of Anaesthesiologists (ASA) scores (89%), rectal cancers (46.1%) and higher tumour stage (65.4%). As a consequence, they were likely to have higher circumferential resection margin positivity (6%, P = 0.02) and to receive adjuvant chemotherapy (57.1%, P < 0.001) compared to their older cohort. Multivariate analysis showed disadvantaged socioeconomic status (odds ratio (OR) 3.3, 95% confidence interval (CI) 1.37–7.94, P < 0.001) and increasing tumour stage (OR 14.9, 95% CI 1.89–116.9, P < 0.001) were independent predictors for circumferential resection margin positivity whereas being female (OR 0.71, 95% CI 0.53–0.95, P = 0.02), higher ASA score (OR 175.3, 95% CI 26.7–1035.5, P < 0.001), urgent surgery (OR 2.75, 95% CI 1.84–4.11, P < 0.001) and anastomotic leak (OR 5.02, 95% CI 3.32–7.58, P < 0.001) were predictors of inpatient mortality. Conclusion There is a steady rise in the incidence of colorectal cancer in younger adults. Both physicians and younger adults should be aware of the potential risk of colorectal cancer (CRC) and appropriate investigations performed so not to delay the diagnosis.