Colorectal cancer in young: a 5-year study from a sub-Saharan African country

Colorectal cancer (CRC) is one of the most frequent malignancies worldwide. There is a global trend in the increase of CRC incidence in younger patients. Our objective is to perform a comparative analysis of CRC in younger patients (˂45 years) and in older patients (≥ 45 years) in a sub-Saharan African country.

Over a period of 5 years, we retrospectively included patients diagnosed with CRC at our Pathology service. We performed statistical comparisons of clinicopathological features between young and older patients with CRC, and searched for risk factors associated with the occurrence of CRC in young patients.

We identified 173 cases of CRC, ranking as the third most common cancer. The mean age was 49 years ± 16.1 (range of 15-84 years), with young patients representing 39.9% (69 cases). Compared to older patients, CRC was more frequent in young females (43.5% versus 28.8%, P = 0.048). Also, CRC in young patients was often associated with mucinous or signet ring cell (SRC) carcinoma histological differentiation (21.7% versus 5.8%, P = 0.002). Although CRC tended to present in more advanced stages (stages III - IV) in young patients, the difference failed to reach statistical difference (47.6% versus 39.5%, P = 0.596). In univariate logistic regression analysis, female sex (Odds ratio (OR) = 1.9, P = 0.049) and mucinous/SRC histological differentiation (OR = 4.59, P = 0.003) were risk factors associated with the occurrence of CRC in young patients.

Colorectal cancer is a frequent malignancy in our country, affecting a substantial proportion of young persons, emphasizing the need for earlier screening. Young patients with CRC present with adverse clinicopathological features in comparison to older patients.