Colorectal cancer in young patients: a retrospective cohort study in a single institution
Background Young onset colorectal cancer is on the rise, with a disproportionate increase in incidence among young people, both in Australia and internationally. Current national guidelines for bowel cancer screening in average risk individuals include only patients greater than 50 years of age. It...
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| Veröffentlicht in: | ANZ journal of surgery 2019-07, Vol.89 (7-8), p.905-907 |
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| creator | Olivo, Rebecca Ratnayake, Sujith |
| description | Background
Young onset colorectal cancer is on the rise, with a disproportionate increase in incidence among young people, both in Australia and internationally. Current national guidelines for bowel cancer screening in average risk individuals include only patients greater than 50 years of age. It is well recognized that colorectal cancer is a highly treatable malignancy when detected at an early stage, and timely diagnosis yields a greater than 90% chance of cure and survival. The aims of this study were to define the clinical presentations leading to colonoscopy in young patients and assess the incidence of malignancy in this group.
Methods
This is a retrospective cohort study including all patients ≤35 years of age without any baseline indication for early bowel cancer surveillance that underwent colonoscopy at Caboolture Hospital from January 2017 to April 2018.
Results
A total of 224 patients underwent colonoscopy in the study period. A total of 210 (93.8%) had symptoms including rectal bleeding (51.7%), altered bowel habit (25.9%), abdominal pain (10.3%) and symptomatic anaemia (6.7%) prior to colonoscopy. Two cases of invasive adenocarcinoma were identified (0.89%, P |
| doi_str_mv | 10.1111/ans.15241 |
| format | Article |
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Young onset colorectal cancer is on the rise, with a disproportionate increase in incidence among young people, both in Australia and internationally. Current national guidelines for bowel cancer screening in average risk individuals include only patients greater than 50 years of age. It is well recognized that colorectal cancer is a highly treatable malignancy when detected at an early stage, and timely diagnosis yields a greater than 90% chance of cure and survival. The aims of this study were to define the clinical presentations leading to colonoscopy in young patients and assess the incidence of malignancy in this group.
Methods
This is a retrospective cohort study including all patients ≤35 years of age without any baseline indication for early bowel cancer surveillance that underwent colonoscopy at Caboolture Hospital from January 2017 to April 2018.
Results
A total of 224 patients underwent colonoscopy in the study period. A total of 210 (93.8%) had symptoms including rectal bleeding (51.7%), altered bowel habit (25.9%), abdominal pain (10.3%) and symptomatic anaemia (6.7%) prior to colonoscopy. Two cases of invasive adenocarcinoma were identified (0.89%, P < 0.01), both of which were symptomatic and were defined as stage IIIB disease on histopathology.
Conclusion
In a theoretically low‐risk population, the incidence of malignancy was nearly 1%. More advanced disease at diagnosis may be due to a delay in investigating these patients due to an overall low suspicion of cancer in young individuals. As such, investigation should be offered early to young patients presenting with any warning symptoms.
Young onset colorectal cancer is on the rise, with a disproportionate increase in incidence among young people. This retrospective cohort study of young patients undergoing colonoscopy shows an incidence rate greater than the age‐standardized incidence rate of colorectal cancer in Australia. Patients found to have malignancy were symptomatic and thus investigation should be offered early to young patients presenting with any warning symptoms. Flexible sigmoidoscopy may be an appropriate alternative to awaiting colonoscopy and lead to earlier diagnosis.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.15241</identifier><identifier>PMID: 31083813</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Adenocarcinoma ; Anemia ; Bleeding ; Cancer ; Cancer screening ; Cohort analysis ; Colon ; Colonoscopy ; Colorectal cancer ; Colorectal carcinoma ; Diagnosis ; Health risk assessment ; Health risks ; Histopathology ; Incidence ; Intestine ; Invasiveness ; Malignancy ; Medical screening ; National Bowel Cancer Screening Program ; Pain ; Patients ; Rectum ; sigmoidoscopy ; Signs and symptoms ; Young adults ; young population</subject><ispartof>ANZ journal of surgery, 2019-07, Vol.89 (7-8), p.905-907</ispartof><rights>2019 Royal Australasian College of Surgeons</rights><rights>2019 Royal Australasian College of Surgeons.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4191-e8167c5367372e94a53cb994d947f2c87282ad6d53b882d1981677b4e6b784f13</citedby><cites>FETCH-LOGICAL-c4191-e8167c5367372e94a53cb994d947f2c87282ad6d53b882d1981677b4e6b784f13</cites><orcidid>0000-0001-8565-326X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.15241$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.15241$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27915,27916,45565,45566</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31083813$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Olivo, Rebecca</creatorcontrib><creatorcontrib>Ratnayake, Sujith</creatorcontrib><title>Colorectal cancer in young patients: a retrospective cohort study in a single institution</title><title>ANZ journal of surgery</title><addtitle>ANZ J Surg</addtitle><description>Background
Young onset colorectal cancer is on the rise, with a disproportionate increase in incidence among young people, both in Australia and internationally. Current national guidelines for bowel cancer screening in average risk individuals include only patients greater than 50 years of age. It is well recognized that colorectal cancer is a highly treatable malignancy when detected at an early stage, and timely diagnosis yields a greater than 90% chance of cure and survival. The aims of this study were to define the clinical presentations leading to colonoscopy in young patients and assess the incidence of malignancy in this group.
Methods
This is a retrospective cohort study including all patients ≤35 years of age without any baseline indication for early bowel cancer surveillance that underwent colonoscopy at Caboolture Hospital from January 2017 to April 2018.
Results
A total of 224 patients underwent colonoscopy in the study period. A total of 210 (93.8%) had symptoms including rectal bleeding (51.7%), altered bowel habit (25.9%), abdominal pain (10.3%) and symptomatic anaemia (6.7%) prior to colonoscopy. Two cases of invasive adenocarcinoma were identified (0.89%, P < 0.01), both of which were symptomatic and were defined as stage IIIB disease on histopathology.
Conclusion
In a theoretically low‐risk population, the incidence of malignancy was nearly 1%. More advanced disease at diagnosis may be due to a delay in investigating these patients due to an overall low suspicion of cancer in young individuals. As such, investigation should be offered early to young patients presenting with any warning symptoms.
Young onset colorectal cancer is on the rise, with a disproportionate increase in incidence among young people. This retrospective cohort study of young patients undergoing colonoscopy shows an incidence rate greater than the age‐standardized incidence rate of colorectal cancer in Australia. Patients found to have malignancy were symptomatic and thus investigation should be offered early to young patients presenting with any warning symptoms. Flexible sigmoidoscopy may be an appropriate alternative to awaiting colonoscopy and lead to earlier diagnosis.</description><subject>Adenocarcinoma</subject><subject>Anemia</subject><subject>Bleeding</subject><subject>Cancer</subject><subject>Cancer screening</subject><subject>Cohort analysis</subject><subject>Colon</subject><subject>Colonoscopy</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Diagnosis</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Histopathology</subject><subject>Incidence</subject><subject>Intestine</subject><subject>Invasiveness</subject><subject>Malignancy</subject><subject>Medical screening</subject><subject>National Bowel Cancer Screening Program</subject><subject>Pain</subject><subject>Patients</subject><subject>Rectum</subject><subject>sigmoidoscopy</subject><subject>Signs and symptoms</subject><subject>Young adults</subject><subject>young population</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp10D1PAyEcBnBiNLZWB7-AIXHRoe3xcge4NY1vSaODOjhdOI5WmitU4DT37aW2OpjIwn_48QAPAKcoG6G0xtKGEcoxRXugjyjNhxgJtr-bESWkB45CWGYZKgqRH4IeQRknHJE-eJ26xnmtomygklZpD42FnWvtAq5lNNrGcAUl9Dp6F9YJmg8NlXtzPsIQ27rbeAmDsYtGpzlEE9tonD0GB3PZBH2y2wfg5eb6eXo3nD3e3k8ns6GiSKCh5qhgKicFIwxrQWVOVCUErQVlc6w4wxzLuqhzUnGOayQ2nlVUFxXjdI7IAFxsc9fevbc6xHJlgtJNI612bSgxJumQwHxDz__QpWu9Ta9LquAYs3RFUpdbpdKPg9fzcu3NSvquRFm56btMfZfffSd7tktsq5Wuf-VPwQmMt-DTNLr7P6mcPDxtI78A7hqIeg</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Olivo, Rebecca</creator><creator>Ratnayake, Sujith</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8565-326X</orcidid></search><sort><creationdate>201907</creationdate><title>Colorectal cancer in young patients: a retrospective cohort study in a single institution</title><author>Olivo, Rebecca ; Ratnayake, Sujith</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4191-e8167c5367372e94a53cb994d947f2c87282ad6d53b882d1981677b4e6b784f13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adenocarcinoma</topic><topic>Anemia</topic><topic>Bleeding</topic><topic>Cancer</topic><topic>Cancer screening</topic><topic>Cohort analysis</topic><topic>Colon</topic><topic>Colonoscopy</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Diagnosis</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Histopathology</topic><topic>Incidence</topic><topic>Intestine</topic><topic>Invasiveness</topic><topic>Malignancy</topic><topic>Medical screening</topic><topic>National Bowel Cancer Screening Program</topic><topic>Pain</topic><topic>Patients</topic><topic>Rectum</topic><topic>sigmoidoscopy</topic><topic>Signs and symptoms</topic><topic>Young adults</topic><topic>young population</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Olivo, Rebecca</creatorcontrib><creatorcontrib>Ratnayake, Sujith</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Olivo, Rebecca</au><au>Ratnayake, Sujith</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Colorectal cancer in young patients: a retrospective cohort study in a single institution</atitle><jtitle>ANZ journal of surgery</jtitle><addtitle>ANZ J Surg</addtitle><date>2019-07</date><risdate>2019</risdate><volume>89</volume><issue>7-8</issue><spage>905</spage><epage>907</epage><pages>905-907</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background
Young onset colorectal cancer is on the rise, with a disproportionate increase in incidence among young people, both in Australia and internationally. Current national guidelines for bowel cancer screening in average risk individuals include only patients greater than 50 years of age. It is well recognized that colorectal cancer is a highly treatable malignancy when detected at an early stage, and timely diagnosis yields a greater than 90% chance of cure and survival. The aims of this study were to define the clinical presentations leading to colonoscopy in young patients and assess the incidence of malignancy in this group.
Methods
This is a retrospective cohort study including all patients ≤35 years of age without any baseline indication for early bowel cancer surveillance that underwent colonoscopy at Caboolture Hospital from January 2017 to April 2018.
Results
A total of 224 patients underwent colonoscopy in the study period. A total of 210 (93.8%) had symptoms including rectal bleeding (51.7%), altered bowel habit (25.9%), abdominal pain (10.3%) and symptomatic anaemia (6.7%) prior to colonoscopy. Two cases of invasive adenocarcinoma were identified (0.89%, P < 0.01), both of which were symptomatic and were defined as stage IIIB disease on histopathology.
Conclusion
In a theoretically low‐risk population, the incidence of malignancy was nearly 1%. More advanced disease at diagnosis may be due to a delay in investigating these patients due to an overall low suspicion of cancer in young individuals. As such, investigation should be offered early to young patients presenting with any warning symptoms.
Young onset colorectal cancer is on the rise, with a disproportionate increase in incidence among young people. This retrospective cohort study of young patients undergoing colonoscopy shows an incidence rate greater than the age‐standardized incidence rate of colorectal cancer in Australia. Patients found to have malignancy were symptomatic and thus investigation should be offered early to young patients presenting with any warning symptoms. Flexible sigmoidoscopy may be an appropriate alternative to awaiting colonoscopy and lead to earlier diagnosis.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>31083813</pmid><doi>10.1111/ans.15241</doi><tpages>3</tpages><orcidid>https://orcid.org/0000-0001-8565-326X</orcidid></addata></record> |
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| subjects | Adenocarcinoma Anemia Bleeding Cancer Cancer screening Cohort analysis Colon Colonoscopy Colorectal cancer Colorectal carcinoma Diagnosis Health risk assessment Health risks Histopathology Incidence Intestine Invasiveness Malignancy Medical screening National Bowel Cancer Screening Program Pain Patients Rectum sigmoidoscopy Signs and symptoms Young adults young population |
| title | Colorectal cancer in young patients: a retrospective cohort study in a single institution |
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