Open AccessTrends and Clinical Outcomes in Young-onset Colorectal Cancer Patients
Author(s) -
Serene Si Ning Goh,
Edith Xl Loo,
Daniel Jk Lee
Publication year - 2020
Publication title -
annals, academy of medicine, singapore/annals of the academy of medicine, singapore
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.299
H-Index - 60
ISSN - 0304-4602
DOI - 10.47102/annals-acadmedsg.20207
Subject(s) - medicine , incidence (geometry) , signet ring cell , perforation , colorectal cancer , hazard ratio , abdominal pain , stage (stratigraphy) , retrospective cohort study , young adult , cancer , gastroenterology , surgery , adenocarcinoma , confidence interval , paleontology , physics , materials science , biology , optics , punching , metallurgy
Young individuals with colorectal cancer (CRC) tend to be diagnosed at advanced stages and are not routinely included in screening programmes. This studydescribes the incidence, disease pattern and factors affecting overall survival in young-onset CRC.Methods: A retrospective study of young-onset CRC patients diagnosed between 2010and 2017 in a tertiary hospital was conducted.Results: There were 99 patients, 69.7% had left-sided while 30.3% had right-sided CRC.The mean age was 43.3 years (43.3±5.0) and 62 patients (62.6%) were male. Theincidence of young-onset CRC has been on the rise since 2014. Out of 99 patients, 65 (65.7%) underwent elective surgery, 30 (30.3%) underwent emergency surgery and the remainder 5 (4.0%) were palliated. The most common presenting complaints for patients who underwent elective surgery were abdominal pain, per-rectal bleeding and alteredbowel habits. For patients who required emergency surgery, 20 (66.6%) presented with intestinal obstruction and 10 (33.3%) had intestinal perforation. There were 42 (42.4%) stage III CRC and 20 (20.2%) stage IV CRC. The most frequent metastatic site was the liver (20/20, 100%). Five patients had signet ring cells (5.1%) in their histology while15 (15.2%) had mucinous features. The overall 5-year survival of young-onset CRCwas 82.0%. Advanced overall stage (hazard ratio (HR) 6.1, CI 1.03–3.62) and signetring histology (HR 34.2, CI 2.24–5.23) were associated with poor prognosis.Conclusion: Young-onset CRC tend to be left-sided with advanced presentations.However, their 5-year survival remains favourable as compared to the general population.Keywords: Colorectal screening in the young, early-onset colorectal cancer, signet ring cell colorectal cancer