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Clinical, Endoscopic and Pathogical Characteristics of Early-Onset Colorectal Cancer in Vietnamese

  • Quach, Duc Trong (Department of Endoscopy, University of Medicine and Pharmacy in Hochiminh City) ;
  • Nguyen, Oanh Thuy (Department of Endoscopy, University of Medicine and Pharmacy in Hochiminh City)
  • Published : 2012.05.30

Abstract

Background: The Asia Pacific consensus for colorectal cancer (CRC) recommends that screening programs should begin by the age of 50. However, there have been reports about increasing incidence of CRC at a younger age (i.e. early-onset CRC). Little is known about the features of early-onset CRC in the Vietnamese population. Aim: To describe the clinical, endoscopic and pathological characteristics of early-onset CRC in Vietnamese. Method: A prospective, cross-sectional study was conducted at the University Medical Center from March 2009 to March 2011. All patients with definite pathological diagnosis of CRC were recruited. The early-onset CRC group were analyzed in comparison with the late-onset (i.e. ${\geq}$ 50-year-old) CRC group. Results: The rate of early-onset CRC was 28% (112/400) with a male-to-female ratio of 1.3. Some 22.3% (25/112) of the patients only experienced abdominal pain and/or change in bowel habit without alarming symptoms, 42.9% (48/112) considering their symptoms intermittent. The rate of familial history of CRC in early-onset group was significantly higher that of the late-onset group (21.4% versus 7.6%, p<0.001). The distribution of CRC lesions in rectum, distal and proximal colon were 51.8% (58/112), 26.8% (30/112) and 21.4% (24/112), respectively; which was not different from that in the late-onset group (${\chi}2$, p = 0.29). The rates for poorly differentiated tumors were also not significantly different between the two groups: 12.4% (14/112) versus 8.3% (24/288) (${\chi}2$, p = 0.25). Conclusion: A high proportion of CRC in Viet Nam appear at an earlier age than that recommended for screening by the Asia Pacific consensus. Family history was a risk factor of early-onset CRC. Diagnosis of early-onset CRC needs more attention because of the lack of alarming symptoms and their intermittent patterns as described by the patients.

Keywords

References

  1. Al-Jaberi TM, Yaghan RJ, El-Heis HA (2003). Colorectal cancer in young patients under 40 years of age. Comparison with old patients in a well defined Jordanian population. Saudi Med J, 24, 871-4.
  2. Fazeli MS, Adel MG, Lebaschi AH (2007). Colorectal carcinoma: a retrospective, descriptive study of age, gender, subsite, stage, and differentiation in Iran from 1995 to 2001 as observed in Tehran University. Dis Colon Rectum, 50, 990-5. https://doi.org/10.1007/s10350-007-0248-z
  3. Foroutan M, Rahimi N, Tabatabaeifar M, et al (2008). Clinical features of colorectal cancer in Iran: a 15-year review. J digestive diseases, 9, 225-7. https://doi.org/10.1111/j.1751-2980.2008.00351.x
  4. Gupta S, Bhattacharya D, Acharya AN, et al (2010). Colorectal carcinoma in young adults: a retrospective study on Indian Patients: 2000-2008. Colorectal Dis, 10, 182-9.
  5. Kahi CJ, Imperiale TF, Juliar BE, et al (2009). Effect of screening colonoscopy on colorectal cancer incidence and mortality. Clin Gastroenterol Hepatol, 7, 770-5. https://doi.org/10.1016/j.cgh.2008.12.030
  6. Karsten B, Kim J, King J, et al (2008). Characteristics of colorectal cancer in young patients at an urban county hospital. Am Surg, 74, 973-6.
  7. Makela JT, Kiviniemi H (2010). Clinicopathological features of colorectal cancer in patients under 40 years of age. Int J Colorectal Dis, 25, 823-8. https://doi.org/10.1007/s00384-010-0914-9
  8. Nath J, Wigley C, Keighley MR, et al (2009). Rectal cancer in young adults: a series of 102 patients at a tertiary care centre in India. Colorectal Dis, 11, 475-9. https://doi.org/10.1111/j.1463-1318.2008.01607.x
  9. Neufeld D, Shpitz B, Bugaev N, et al (2009). Young-age onset of colorectal cancer in Israel. Tech Coloproctol, 13, 201-4. https://doi.org/10.1007/s10151-009-0501-7
  10. Peedikayil MC, Nair P, Seena SM, et al (2009). Colorectal cancer distribution in 220 Indian patients undergoing colonoscopy. Indian J Gastroenterol, 28, 212-5. https://doi.org/10.1007/s12664-009-0087-z
  11. Rex DK, Johnson DA, Anderson JC, et al (2009). American college of gastroenterology guidelines for colorectal cancer screening 2009 [corrected]. Am J Gastroenterol, 104, 739-50. https://doi.org/10.1038/ajg.2009.104
  12. Savas N, Dagli U, Akbulut S, et al (2007). Colorectal cancer localization in young patients: should we expand the screening program?. Dig Dis Sci, 52, 798-802. https://doi.org/10.1007/s10620-006-9432-6
  13. Siegel RL, Jemal A, Ward EM (2009). Increase in incidence of colorectal cancer among young men and women in the United States. Cancer Epidemiol Biomarkers Prev, 18, 1695-98. https://doi.org/10.1158/1055-9965.EPI-09-0186
  14. Stryker SJ, Wolff BG, Culp CE, et al (1987). Natural history of untreated colonic polyps. Gastroenterology, 93, 1009-13. https://doi.org/10.1016/0016-5085(87)90563-4
  15. Sung JJ, Lau JY, Young GP, et al (2008). Asia Pacific consensus recommendations for colorectal cancer screening. Gut, 57, 1166-76. https://doi.org/10.1136/gut.2007.146316
  16. Umar A, Boland CR, Terdiman JP, et al (2004). Revised bethesda guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst, 96, 261-8. https://doi.org/10.1093/jnci/djh034
  17. Winawer SJ, Zauber AG, Ho MN, et al (1993). Prevention of colorectal cancer by colonoscopic polypectomy. The national polyp study workgroup. N Engl J Med, 329, 1977-81. https://doi.org/10.1056/NEJM199312303292701
  18. Yantiss RK, Goodarzi M, Zhou XK, et al (2009). Clinical, pathologic, and molecular features of early-onset colorectal carcinoma. Am J Surg Pathol, 33, 572-82. https://doi.org/10.1097/PAS.0b013e31818afd6b

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