Malignant colorectal tumours in patients 30 years and below: a review of 35 cases.

OBJECTIVE

To review malignant colorectal tumour arising in patients 30 years and below.

DESIGN

Retrospective cross sectional descriptive study.

SETTING

Jos University Teaching Hospital, Jos, Nigeria.

SUBJECTS

A total of 35 patients 30 years and below.

MAIN OUTCOME MEASURES

Occurrence of malignant colorectal tumours tends to be higher among men and women over age 65 years and more common among Whites than Blacks. The disease rarely presents in the young population and the prognosis is usually unfavourable. This may be due to a delay in the diagnosis because colorectal cancer is not usually considered first in this age group.

INTERVENTIONS

15 patients had abdomino-perineal excision of the rectum, two right hemicolectomy, one left hemicolectomy, two anterior resection and six had colostomy and biopsy.

RESULTS

Altogether, 149 patients were treated for large bowel cancer. From then, 35 (23.6%) given a yearly incidence of 3.5 were 30 years old or younger. The mean age was 25 (STD +/- 6) years, while the M:F ratio was 1.2:1. Weight loss, bloody mucoid diarrhoea, tenesmus and an anorectal mass were common clinical features present for more than six months. The rectum was involved in 24 patients (68.6%) and adenocarcinoma either well/moderately well differentiated or poorly differentiated was the predominant histological type. All the cancers except four were advanced at first presentation and treatment was merely palliative with only 30% of those treated and followed up still alive at six months. Complications of surgery were considered minor with the exception of the pelvic abscesses and deaths were due to the effects of the disease.

CONCLUSIONS

This study illustrates that colorectal cancer is not rare, as it was previously believed. Presentation is commonly late and prognosis poor. In this age group, malignant colorectal tumours should frequently be considered in the differential diagnosis of bowel symptoms. The importance of the prudence of the general practitioner is thus emphasized.