Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi, India.
Department of Laboratory and Transfusion Services, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi, India.
Indian J Cancer. 2021 Jul-Sep;58(3):355-364. doi: 10.4103/ijc.IJC_246_19.
Colorectal cancer (CRC) is mostly considered a disease of the elderly. But the rate is increasing among young adults and is associated with different clinical patterns. The objective was to study the frequency of CRC in young patients and compare the clinicopathological profile and survival with the older cohort.
Five-year (2012-2016) data of the 912 consecutive CRC cases treated at the center were analyzed. Clinical and histopathological characteristics were compared in young (≤40) and older (>40) patients. Descriptive statistics were used for data presentation. Categorical data were compared by the Chi-square test; survival analyses were performed by Kaplan-Meier method.
In total, 231 (25.3%) and 681 (74.7%) cases were in the young and older age groups, respectively. Male predominance was noted. Young patients presented predominantly in stage III (46%). Majority of the young patients harbored left-sided tumors (75.8% vs 63.7% in old patients, P = 0.001) and rectum was the favored site in young patients (53.7% vs 37%; P < 0.001). Poorly differentiated adenocarcinoma was more common in the young age group (46.88% vs 24.16% in old patients, P < 0.001), also signet-ring cell morphology occurred more often in young patients (11.7% vs 4%, P < 0.001). Survival was inferior in the patients presenting at an advanced stage or with adverse histology or poor tumor grade. However, stage-specific survival showed no significant difference between both groups.
This study shows that though young CRC patients present with higher stage, aggressive morphology, and predominantly rectal localization, the overall survival and stage-specific survival did not differ significantly from the older patients.
结直肠癌（CRC）主要被认为是一种老年病。但在年轻人中的发病率正在上升，并与不同的临床模式相关。本研究旨在探讨年轻患者中 CRC 的发病频率，并将其临床病理特征与老年患者进行比较。
对中心 912 例连续 CRC 病例的 5 年（2012-2016 年）数据进行分析。比较年轻（≤40 岁）和老年（>40 岁）患者的临床和组织病理学特征。采用描述性统计方法进行数据呈现。使用卡方检验比较分类数据；采用 Kaplan-Meier 法进行生存分析。
共 231 例（25.3%）和 681 例（74.7%）患者分别归入年轻和老年年龄组。男性占优势。年轻患者主要处于 III 期（46%）。大多数年轻患者肿瘤位于左侧（75.8%比老年患者的 63.7%，P=0.001），且年轻患者更倾向于直肠部位（53.7%比 37%，P<0.001）。年轻患者中低分化腺癌更为常见（46.88%比老年患者的 24.16%，P<0.001），且年轻患者中出现印戒细胞形态的比例更高（11.7%比 4%，P<0.001）。在晚期、组织学不良或肿瘤分级差的患者中，生存情况较差。然而，两组的特定分期生存情况无显著差异。
本研究表明，尽管年轻 CRC 患者表现出更高的分期、侵袭性形态和主要直肠定位，但总体生存和特定分期生存与老年患者无显著差异。
