Colorectal cancer localization in young patients: should we expand the screening program?

We sought to investigate the frequency and distribution of colorectal cancer (CRC) in patients by age and to evaluate whether there is a difference between young (<40 years of age) and older patients ( > or = 40 years of age) with regard to cancer localizations. From a total of 5165 colonoscopies, 314 (6.0%) cases were identified to have colorectal carcinoma. Forty-one (13%) of 314 CRC patients were young, with a mean age of 31.1 +/- 5.7 years. When cancer localizations were compared with reference to age, it was seen that CRCs in young patients were mostly localized at the right colon, versus at the left colon and rectum (P = 013) in patients >40 years of age. Tumor localizations in colon cancer patients change with age. In our study, young patients tended to have right-sided colon tumors, but those in patients >40 years of age were frequently localized at the left colon and rectum.