Although colorectal cancer is a disease of the older population, these tumors are not infrequent before the age of 55. Through the data of a population-based registry, we proposed giving a description of the clinical features of three groups of patients in whom the disease occurred at a relatively early age of onset (group I: < 40 yr; group II: 41-50 yr; group III: 51-55 yr). There were only 14 patients under, the age of 40 yr (1.1% of total registered patients, n = 1298 in the period 1984-1992). Group II and III represented 5.9% and 6.0%, respectively (n = 76 and 78), with minor fluctuations through-out the 9-yr period of registration. Inherited colorectal tumors [hereditary nonpolyposis colorectal cancer (HNPCC), adenomatosis coli, and suspected HNPCC] accounted for 38.4% of group I patients (5 of 14), 17.1% of group II, 10.2% of group III, and only 3.5% of individuals older than 55 (p, for trend, < 0.001). Thus, hereditary colorectal tumors were detected significantly more often in younger individuals. The majority of colorectal malignancies were localized in the left colon or rectum in all three groups, with a tendency (not significant) to a preferential localization in the right colon for tumors developed in group I (37% vs 18% and 14% in groups II and III, respectively). Pathological stage and main histological types did not differ among the three groups; Finally, life-table analysis did not show significant differences in 5-yr survival among the three groups; however, when considered together, early onset cases showed a more favorable prognosis than older individuals (log- rank 11.6; p < 0.001). In conclusion, colorectal cancer is diagnosed very rarely before the age of 40 yr, whereas about 12% of all cases belong to the age group 41 to 55 yr of age. Hereditary tumors were found more frequently in younger patients; with a well-defined inverse relationship between age of onset and frequency of genetically determined tumors. Finally, the clinical out-come was more favorable in the whole series of early onset cases than in older registered patients.
Colorectal carcinoma in different age groups: A population-based investigation / Fante, R.; Benatti, P.; Di Gregorio, C.; De Pietri, S.; Pedroni, M.; Tamassia, M. G.; Percesepe, A.; Rossi, G.; Losi, L.; Roncucci, L.; Ponz de Leon, M.. - In: AMERICAN JOURNAL OF GASTROENTEROLOGY. - ISSN 0002-9270. - 92:9(1997), pp. 1505-1509.
|Appare nelle tipologie:||1.1 Articolo su rivista|