Colorectal Cancer Patients Diagnosed Younger

About one in seven colorectal cancer patients are diagnosed before they reach the recommended screening age of 50 years, according to findings published in Cancer.Researchers from the University of Michigan Health System conducted a population based, retrospective cohort study to determine the national treatment patterns and outcomes in colorectal cancer patients. The quarter-million patients in the study were recruited from the nationally representative Surveillance, Epidemiology and End Registry for patients diagnosed with colorectal cancer between 1998 and 2011.

The researchers categorized the patients into groups based on if they were younger or older than the recommended screening age. They compared the patient groups for stage of disease at diagnosis, patterns of therapy and disease specific survival.

About 15% of patients, or one of seven, were diagnosed with colorectal cancer before age 50 years. These young patients typically presented with regional or distant disease, the researchers reported.

When these young patients had colorectal cancer, their distant metastatic was treated with surgical therapy for their primary tumor. But, the researchers added, radiotherapy was also common in these patients.

“Colorectal cancer has traditionally been thought of as a disease of the elderly,” study author Samantha Hendren, MD, MPH, explained in a press release. “This study is really a wake up call to the medical community that a relatively large number of colorectal cancers are occurring in people under 50. To put this in context, breast cancer screening often begins at age 40, and less than 5% of invasive breast cancers occur in women under that age. Our study found that about 15% of colorectal cancers are diagnosed before the screening age of 50.”

Patients under 50 years of age had better disease specific survival even though a larger percentage of these individuals presented with more advanced forms of the disease.

“These findings suggest the need for improved risk assessment and screening decisions for younger adults,” the study authors conclude. However, Hendren continued in the statement that these findings don’t necessary mean guidelines should change.

“[That] would be a big and costly change, and I don’t know whether it would help more people than it would hurt,” she said. “A lot of research would be required to understand this before any changes should be made. The cancer community needs to prepare for the increasing number of very young colorectal cancer survivors who will need long term support to cope with the physical and psychological consequences of their disease and treatments.”