COLORECTAL-CANCER IN THE YOUNG PATIENT

Although predominantly a disease of older adults, colorectal cancer af fects the younger population with an incidence of two to six per cent. It is thought to carry a less favorable prognosis in the young than i n the general population. This may be due to advanced stage of the tum or at diagnosis. This study is composed of 37 patients, aged 40 and yo unger, treated over a 20-year period for colorectal cancer at Louisian a State University Medical Center-Shreveport and E. A. Conway Hospital . It was performed to investigate the incidence, stage at diagnosis, a nd prognosis of colorectal cancer in these young patients. The locatio n of the primary tumor was fairly evenly distributed throughout the co lon and rectum in this population. Pain, weight loss, rectal bleeding, and nausea and vomiting were the mast common presenting symptoms. A f amily history of colon cancer or premalignant lesions were not risk fa ctors in this study. Seventy per cent of all patients were treated wit h curative intent, and 42 per cent of these patients developed recurre nt disease. The patients in this review presented with a higher incide nce of advanced disease. Thirty-seven per cent of the lesions were Duk e's C and 22 per cent were Duke's D, with poor 5-year survival (11% an d 0%, respectively) when compared with national studies. The absolute 5-year survival for all young patients with colorectal canter was 26 p er cent (5 of 19 patients). It is important for the surgeon to be awar e of the potential for colorectal cancer in young patients and to take an aggressive approach to the diagnosis and early treatment of the di sease.