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Colorectal cancer in young adults: Experience of the medical oncology department of Fez
Background
The recent rise of young individuals under age 50 with colorectal cancer (CRC) is a startling trend in need of greater focus and research. The rapid increase in incidence rates among young people could result from generational differences in diet, environmental exposures and lifestyle factors. The aim of this study is to describe the epidemiological changes as well as the differences in the clinicopathologic, molecular characteristics of young patients.
Methods
This is a retrospective study of young patient with colorectal cancer aged < 45 and treated at the medical oncology department of Fez over a period from December 2009 to September 2020. The Kaplan Meier method was used to estimate the median survival.
Results
- 158 (24% ) patients were young, of whom 16% had family history, and 11% were obese. Mucinous adenocarcinoma was present in 53%. 46% were at the metastatic stage, of which 80% had a poorly differentiated character. At stage II, MSI status was present in 62%. The mutated RAS status was 40%.51% received trichemotherapy versus 49% bichemotherapy. The preferential site was in 52% the liver, 30% the lung and the bone in 16%. However, young patients diagnosed with early-stage tumors had a significantly better prognosis compared to early-stage tumors in the older age group. The majority of young patients with colorectal cancer often receive more aggressive treatment regimens than their older counterparts. Median overall survival in young patients was 16 months.
Conclusions
Early-onset colorectal carcinoma are a distinct clinical group characterized by poor cellular differentiation and aggressive evolution. Several factors may well explain this apparent epidemic among young people, namely and emerging lifestyle issues such as obesity, lack of exercise and dietary factors.
Legal entity responsible for the study
The author.
Funding
Department of Medical Oncology, Fez.
Disclosures
All authors have declared no conflicts of interest.
