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Young-onset colon cancers present with physical symptoms, left-side disease

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ORLANDO — Patients with young-onset colorectal cancer commonly presented with physical symptoms such as rectal bleeding, pain and bloating and nearly 70% presented with left-side disease. Younger patients were more likely to have hypertension and diabetes and less likely to have ever smoked, according to research presented at the World Congress of Gastroenterology at ACG 2017.

“To date, this is the largest single-center study describing the demographics, clinical and pathologic features of young-onset colorectal cancer,” Leslie Park, MD, of Memorial Sloan-Kettering Cancer Center, said during her presentation.

The researchers set out to better understand common characteristics associated with young-onset colorectal cancer among 3,238 patients (median age, 44; 52% male) who received care at Memorial Sloan-Kettering Cancer Center between January 2004 and April 2015. Data were pooled on patient demographics, presenting symptoms, smoking history, family history of cancer, medical and surgical history, tumor characteristics and pathology. Patients were excluded if they had a history of hereditary colon cancer syndrome, inflammatory bowel disease or were previously diagnosed with colorectal cancer.

Baseline characteristics of patients were then compared with a nationally representative cohort of cancer-free controls aged 20 to 49 years included in the National Health and Nutrition Examination Survey (NHANES).

Common presenting symptoms among young-onset colorectal cancer patients included rectal bleeding (49%), abdominal pain and bloating (33%) and changes in bowel habits (25%). Most patients with young-onset colorectal cancer presented with cancers of the left-side (69%), late-stage disease (65% stage 3 or 4 disease) and did not have a family history of colorectal cancer (68%).

“Colorectal cancer should be considered in young patients who present with these symptoms and should be followed very closely to determine whether further evaluation is warranted,” Park said.

Results showed that patients with young-onset colorectal cancer were more likely to have hypertension (16.9% vs. 16.4%) and diabetes (5.5% vs. 3.3%), and less likely to have ever smoked (28.3% vs. 42.3%) when compared with cancer-free controls.

Reference: Park L, et al. Abstract 36. Presented at: World Congress of Gastroenterology; Oct. 13-18, 2017; Orlando.

Disclosure: Park reports no relevant financial disclosures.