Quach Duc Trong, Nguyen Oanh Thuy
Department of Endoscopy, University of Medicine and Pharmacy in Hochiminh City, Vietnam.
Asian Pac J Cancer Prev. 2012;13(5):1767-70. doi: 10.7314/apjcp.2012.13.5.1767.
The Asia Pacific consensus for colorectal cancer (CRC) recommends that screening programs should begin by the age of 50. However, there have been reports about increasing incidence of CRC at a younger age (i.e. early-onset CRC). Little is known about the features of early-onset CRC in the Vietnamese population.
To describe the clinical, endoscopic and pathological characteristics of early-onset CRC in Vietnamese.
A prospective, cross-sectional study was conducted at the University Medical Center from March 2009 to March 2011. All patients with definite pathological diagnosis of CRC were recruited. The early-onset CRC group were analyzed in comparison with the late-onset (i.e.≥50-year-old) CRC group.
The rate of early-onset CRC was 28% (112/400) with a male-to-female ratio of 1.3. Some 22.3% (25/112) of the patients only experienced abdominal pain and/or change in bowel habit without alarming symptoms, 42.9% (48/112) considering their symptoms intermittent. The rate of familial history of CRC in early-onset group was significantly higher that of the late-onset group (21.4% versus 7.6%, p<0.001). The distribution of CRC lesions in rectum, distal and proximal colon were 51.8% (58/112), 26.8% (30/112) and 21.4% (24/112), respectively; which was not different from that in the late-onset group (χ2, p=0.29). The rates for poorly differentiated tumors were also not significantly different between the two groups: 12.4% (14/112) versus 8.3% (24/288) (χ2, p=0.25).
A high proportion of CRC in Viet Nam appear at an earlier age than that recommended for screening by the Asia Pacific consensus. Family history was a risk factor of early-onset CRC. Diagnosis of early-onset CRC needs more attention because of the lack of alarming symptoms and their intermittent patterns as described by the patients.
亚太地区结直肠癌（CRC）共识建议筛查计划应从50岁开始。然而，有报道称结直肠癌在较年轻年龄段（即早发性结直肠癌）的发病率呈上升趋势。对于越南人群中早发性结直肠癌的特征知之甚少。
描述越南早发性结直肠癌的临床、内镜及病理特征。
2009年3月至2011年3月在大学医学中心进行了一项前瞻性横断面研究。招募所有经病理确诊为结直肠癌的患者。将早发性结直肠癌组与晚发性（即≥50岁）结直肠癌组进行对比分析。
早发性结直肠癌的发生率为28%（112/400），男女比例为1.3。约22.3%（25/112）的患者仅出现腹痛和/或排便习惯改变，无警示症状，42.9%（48/112）的患者认为其症状为间歇性。早发性组结直肠癌家族史的比例显著高于晚发性组（21.4%对7.6%，p<0.001）。结直肠癌病变在直肠、结肠远端和近端的分布分别为51.8%（58/112）、26.8%（30/112）和21.4%（24/112）；与晚发性组无差异（χ2，p=0.29）。两组中低分化肿瘤的比例也无显著差异：12.4%（14/112）对8.3%（24/288）（χ2，p=0.25）。
越南相当一部分结直肠癌发病年龄早于亚太地区共识推荐的筛查年龄。家族史是早发性结直肠癌的一个危险因素。由于缺乏患者所述的警示症状及其间歇性特征，早发性结直肠癌的诊断需要更多关注。
