Is colorectal neoplasia more aggressive in the young? A look at shifting guidelines

This study aimed to compare factors associated with CRC in patients younger than 50 and in those 50 and older, that required surgical resection due to malignancy or premalignant conditions.

A retrospective chart review was conducted looking at patients who had bowel resection due to CRC or advanced polyps; individuals found to have hereditary tumors and inflammatory bowel disease were excluded. Data was analyzed with chi square test of association comparing proportions of patients in the two age groups.

A significantly higher proportion of the younger population had advanced stages of CRC. Data from this and other studies suggests that the colorectal tumors seen in patients under 50 have a higher virulence, and perhaps this is due to different tumor biology.

These findings illustrate how changes in screening guidelines reinforced by proper support from insurance providers/payors and a widespread aggressive educational campaign for patients and providers can benefit this increasingly vulnerable population.