Colorectal cancer in young patients: is it a distinct clinical entity?

Hadar Goldvaser, Ofer Purim, Yulia Kundel, Daniel Shepshelovich, Tzippy Shochat, Lital Shemesh-Bar, Aaron Sulkes, Baruch Brenner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: The incidence of colorectal cancer in young patients is increasing. It remains unclear if the disease has unique features in this age group. Methods: This was a single-center, retrospective cohort study which included patients diagnosed with colorectal cancer at age ≤40 years in 1997–2013 matched 1:2 by year of diagnosis with consecutive colorectal cancer patients diagnosed at age >50 years during the same period. Patients aged 41–50 years were not included in the study, to accentuate potential age-related differences. Clinicopathological characteristics, treatment, and outcome were compared between groups. Results: The cohort included 330 patients, followed for a median time of 65.9 months (range 4.7–211). Several significant differences were noted. The younger group had a different ethnic composition. They had higher rates of family history of colorectal cancer (p = 0.003), hereditary colorectal cancer syndromes (p < 0.0001), and inflammatory bowel disease (p = 0.007), and a lower rate of polyps (p < 0.0001). They were more likely to present with stage III or IV disease (p = 0.001), angiolymphatic invasion, signet cell ring adenocarcinoma, and rectal tumors (p = 0.02). Younger patients more frequently received treatment. Young patients had a worse estimated 5-year disease-free survival rate (57.6 vs. 70 %, p = 0.039), but this did not retain significance when analyzed by stage (p = 0.092). Estimated 5-year overall survival rates were 59.1 and 62.1 % in the younger and the control group, respectively (p = 0.565). Conclusions: Colorectal cancer among young patients may constitute a distinct clinical entity. Further research is needed to validate our findings and define the optimal approach in this population.

Original languageEnglish
Pages (from-to)684-695
Number of pages12
JournalInternational Journal of Clinical Oncology
Issue number4
StatePublished - 1 Aug 2016


  • Age
  • Carcinoma
  • Colon
  • Rectum
  • Young


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