Large-bowel cancer in the young: a national survival study

Large-bowel cancer in young patients is reported to be a more aggressive and advanced disease at presentation and is believed to be associated with a relatively poor prognosis. Of 2420 patients registered in New Zealand (1968 to 1970), 131 were under 40 years of age and 2289 were over 40 years of age. The annual average incidence of treatable colorectal cancer in patients under 40 years of age was 2.36 per 100,000 and 82.93 in patients over 40 years of age. There were predominantly more females in both age groups with colonic tumors, 50:44 (female:male), and 759:652 (female:male). The rectal tumor male-to-female ratio of 1:0.68 in those over 40 years of age was reversed in those under 40 years of age (1:2.08). There was no significant difference in the subsite distribution of colorectal cancer between the two groups. There was a higher proportion of Stage 1 tumors in those under 40 years of age and a correspondingly higher proportion of Stage 2 tumors in those over 40 years of age. The overall crude and relative five-year survival rates for patients under 40 years of age were both 60 percent, whereas the crude rate for older patients was 42 percent, with a corresponding relative rate of 53 percent. Ten-year survival rates were generally higher in younger patients. From this study, there was no evidence to suggest that younger patients (less than 40 years old) with colorectal cancer had worse prognoses and did not survive as long as older patients (40 years and over).