Colon cancer in the young: contributing factors and short-term surgical outcomes

The incidence in young patients has increased significantly over the last few decades. The aim of this study is to evaluate demographic and tumor characteristics of young patients and analyze the short-term surgical outcomes of patients undergoing surgery.

We performed a 2-year review (2015-2016) of the ACS-NSQIP and included all patients with CC who underwent surgical management. Patients were stratified into two groups: early-onset CC (< 50 years old) and late-onset CC (≥ 50 years old). Outcome measures were hospital length of stay, 30-day complications, mortality, and readmission.

We included a total of 15,957 patients in the analysis. Mean age was 65 ± 13 years, and 52% were male. Overall 10% of the patients had early-onset CC. Patients with early-onset CC were more likely to be black (11% vs 7%, p = 0.04) and Hispanic (8% vs 4%, p = 0.02). Additionally, they presented with a more aggressive tumor and higher TNM staging. Patients with early onset CC had lower 30-day complications (18% vs 22%, p = 0.02), shorter hospital length of stay (6[3-8] vs 8[5-11], p = 0.03) and lower 30-day mortality (0.4% vs 1.8%, p = 0.04) compared to their counterparts. However, there was no difference between the two groups regarding 30-day readmission. On regression analysis, there was no difference between the two groups regarding study outcomes.

Racial disparity does exist in the incidence of colon cancer in the young with higher incidence in blacks. Younger patients with CC tend to have better surgical outcomes on univariate analysis. On regression analysis, the surgical outcomes between the two groups are comparable.