Colorectal Cancer in Different Age Groups in a Tertiary Hospital in Nepal
Introduction: Some studies have suggested that colorectal cancer at a younger age had distinct biological characteristics: different clinical presentations, more advanced stage at time of diagnosis and poorly differentiated carcinoma. The aim of the study is to analyze clinical and histopathological differences between younger (≤40 years of age) and older (>40 years of age) colorectal cancer patients.
Methods: A cross-sectional analysis was conducted amongst the colorectal cancer patients who visited Bir Hospital between July 2015 and April 2017. All colonoscopically diagnosed and histopathologically proven cases of colon cancer were included. Chi-square test and independent t – test was performed to analyze the difference between clinical presentations and histopathological findings among two groups of patients and p value of <0.05 was considered as significant.
Results: Thirty younger patients and thirty older patients were enrolled without any differences in gender proportion. There were no statistical differences between clinical presentation and histological grade and type in younger and older patients. The younger patients had more complaints of altered bowel habit (p <0.001) while older patients mostly presented with per rectal bleeding (p< 0.008).
Conclusions: In this study, colorectal cancer at younger ages showed similar characteristics to those of older patients except altered bowel habit was more common in younger patients while per rectal bleeding was more common in older patients. Although colorectal cancer incidence increases with age, younger patients with altered bowel habits, weight loss, anemia and anorexia should also be given due medical attention and undergo evaluation promptly.
Keywords: carcinoma; colon; per rectal bleeding; younger group. [PubMed]
2. Hamilton SR, Bosman FT, Boffetta P, et al. Carcinoma of the colon and rectum. WHO Classification of Tumors of the Digestive System 4th ed. 2010; p. 134-46.
3. Pradhananga KK, Baral M, Shrestha BM. Multi-institution hospital-based cancer incidence data for Nepal: an initial report. Asian Pac J Cancer Prev. 2009 Apr-Jun; 10(2):259-62. [PubMed |Full Text]
4. Kansakar P, Singh Y. Changing trends of colorectal carcinoma in Nepalese young adults. Asian Pac J Cancer Prev. 2012;13(7):3209-12. [PubMed | Full Text]
5. Singh Y, Vaidya P, Hemandas AK, Singh KP. Colorectal carcinoma in Nepalese young adults: presentation and outcome. Gan To Kagaku Ryoho. 2002 Feb; 29(1): 223–29[PubMed.
6. De silva MV, Fernando MS, Fernando . Comparison of some clinical and histological features of colorectal carcinoma occurring in patients below and above 40yrs. Ceylon Med J. 2000 Dec;45(4):166-8. [PubMed]
7. Mitry E, Benhamiche AM, Jouve JL, et al. Colorectal adenocarcinoma in patients under 45 years of age: comparison with older patients in a well-defined French population. Dis Colon Rectum. 2001 Mar; 44:380–7. [PubMed]
8. Nurdjanah S, Taroeno S, Bayupurnama P, Maduseno S, Ratnasari N. Colorectal cancer in young patient: a distinguished disease entity? Indonesian J Gastroenterol Hepatol Digest Endosc. 2005; 6:37-41. [Full Text]
9. Al-Jaberi TM, Yaghan RJ, El-Heis HA. Colorectal cancer in young patients under 40 years of age. Comparison with old patients in a well-defined Jordanian population. Saudi Med J. 2003; 8:871-4. [PubMed]
10. Bossola M, Sofo L, Ratto C, et al. Colorectal cancer in patients 40 years of age and younger . Itali J Surg Sci. 1989;19(4):361-7. [PubMed]
11. Fazeli MS, Adel MG, Lebaschi AH. Colorectal carcinoma: a retrospective, descriptive study of age, gender, subsite, stage and differentiation in Iran from 1995 to 2001 as observed in Tehran University. Dis Colon Rectum. 2007 Jul;50(7):990. [PubMed]
12. Gupta S, Bhattacharya D, Acharya AN, Majumdar S, Ranjan P, Das S. Colorectal cancer in young adults: a retrospective study on Indian Patients: 2000-2008. Colorectal Dis. 2010 Oct;12(10):e 182-9. [PubMed | DOI | Full Text ]
13. Soliman AS, Bondy ML, Levin B, et al. Colorectal cancer in Egyptian patients under 40 yrs of age. Int J Cancer. 1997;71:26-30. [PubMed | DOI | Full Text ]
14. Wu X, Chen VW, Martin J, et al. Subsite-specific colorectal cancer incidence rates and stage distributions among Asians and Pacific Islanders in the United states, 1995 to 1999. Cancer PubMed Epidemiol Biomarkers Prev. 2004 Jul;13(7):1215-22 . [PubMed | Full Text]
Copyright (c) 2017 Nandu Silwal Poudyal, Sitaram Chaudhary, Bhupendra Kumar Basnet, Bidhan Nidhi Poudel, Barun Shrestha, Amrendra Kumar Mandal, Mukesh Sharma
This work is licensed under a Creative Commons Attribution 4.0 International License.
JNMA allow to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. The author(s) are allowed to retain publishing rights without restrictions. The JNMA work is licensed under a Creative Commons Attribution 4.0 International License. More about Copyright Policy.