Colorectal cancer in younger patients

Colorectal cancer is uncommon in India and particularly so in the younger age group below 40 years. The present study reports 18 patients with colorectal cancer between the age of 21 to 30 years. Rectum (n = 15, 83%) was the commonest site of the lesion and rectal bleed was the presenting feature in most (n = 16, 89%). Histopathologically, 9 (50%) had poorly differentiated adenocarcinoma. The tumor was unresectable in 5 patients (28%). Fourteen patients (78%) had advanced cancer indicated by TNM stage III or IV disease. Among the 13 patients subjected to surgical treatment followed by adjuvant chemotherapy, only 3 had long term disease free survival beyond 2 years. None of these patients had family history of colonic cancer or polyposis coli. In conclusion, colorectal cancer in younger age is not infrequent and had advanced stage at the time of clinical presentation with poor outcome.