Colorectal carcinoma up to the second decade of life: An 8-year experience in a tertiary care center

Indian J Cancer. 2014 Oct-Dec;51(4):557-9. doi: 10.4103/0019-509X.175313.

Abstract

Aims and objectives: To evaluate the demographic pattern, incidence, and histological characteristics of colorectal carcinomas (CRCs) in very young adults diagnosed in the center.

Materials and methods: We retrieved and reviewed slides and data pertaining to all the cases of CRCs and "segregated into decade wise age-groups" from the archives of Department of Pathology. Patients with age ≤20 years diagnosed during the last 8 years (2006-2013) were further evaluated.

Results: Totally, 590 cases of CRCs diagnosed over last 8-year period, of which 4.2% (25 cases) presented in the study group (age ≤20 years) with a mean age of 17 years. About 50% of the tumors were either signet ring cell, mucin-secreting or poorly differentiated carcinomas. Four cases occurred in a background of familial adenomatous polyposis (FAP), three of which showed high-grade dysplasia, while in one case, carcinoma-in-situ was diagnosed. In all but two cases, rectum was the site of involvement except FAP cases in which colorectal location was noted. CRCs show a sharp rise in earlier age onset (≤40 years) and an increasing trend was followed in patients between age groups third, fourth, and fifth decades of life over the last 8 years.

Conclusion: Colorectal carcinomas show an increasing trend in young age (≤40 years). This change may be attributed to dietary, lifestyle changes, and newer genetic alterations in developing countries. In very young age group (≤20 years), a higher grade and stage at the time of diagnosis and predominantly rectal involvements are the distinct features.

MeSH terms

  • Adenocarcinoma, Mucinous / epidemiology*
  • Adenocarcinoma, Mucinous / pathology
  • Adenomatous Polyposis Coli / epidemiology
  • Adenomatous Polyposis Coli / pathology
  • Adolescent
  • Age of Onset
  • Carcinoma, Signet Ring Cell / epidemiology*
  • Carcinoma, Signet Ring Cell / pathology
  • Colonic Neoplasms / epidemiology*
  • Colonic Neoplasms / pathology
  • Female
  • Humans
  • Incidence
  • India / epidemiology
  • Male
  • Rectal Neoplasms / epidemiology*
  • Rectal Neoplasms / pathology
  • Tertiary Care Centers
  • Young Adult