Colorectal cancer before the age of 40 - A case-control study

PURPOSE: Colorectal adenocarcinoma before the age of 40 is uncommon, and it s prognosis is controversial, with many studies reporting a worse prognosis than in older patients and others showing no difference. The current study compared two groups of patients who had surgical resection for colorectal adenocarcinoma. METHODS: The case group was composed of 34 patients younger than 40 (34 +/- 4) years. Detailed pathologic prognosis factors, tumor cel l proliferation measured by proliferating cell nuclear antigen, survival, f amily history, and predisposing conditions were analyzed. Results were comp ared with a control group constituted of 34 patients older than 65 (75 +/- 6) years matched by gender, cancer site, and Dukes stage. RESULTS: Tumor di fferentiation, presence of vascular and perineural neoplastic invasion, tum or growth pattern, tumor cell proliferation measured by proliferating cell nuclear antigen count, and survival according to the Kaplan-Meier method we re not significantly different between younger and older patients. The only difference between the two groups was a higher prevalence of family histor y and predisposing conditions for colorectal cancer in younger patients (23 vs 3 percent; P = 0.03). CONCLUSION: This case-control study documents tha t pathologic features and prognosis of colorectal adenocarcinoma are compar able in patients younger than 40 years compared with older patients fur ide ntical stages. The higher prevalence of positive family history in younger patients suggests a different genetic background compared with older patien ts.