Clinicopathological Characteristics of Chinese Colorectal Cancer Patients under 30 Years of Age: Implication in Diagnosis and Therapy

Objectives: The incidence of colorectal cancer (CRC) is increasing in younger populations; the characteristics and prognosis of those younger patients are not fully understood. The aim of this retrospective study was to analyze the clinicopathological features of Chinese CRC patients under 30 years of age. Methods: We reviewed the clinical and pathological features of 83 CRC patients (33 males and 50 females) aged 13-30 years (mean, 26.1 years) selected from consecutive 5,830 patients with primary CRC referred to Shanghai Changzheng Hospital between January 1995 and December 2013. Results: The duration from the onset of symptoms to diagnosis ranged from 3 days to 24.0 months (average 4.6 months). The most common symptom at the time of diagnosis was bloody stool, occurring in 66.3% of the patients. 60.2% patients had tumors located in the rectum and 72.8% of them presented advanced diseases (TNM stage III or IV). More male patients presented as M1 stage than the female patients. Patients with CRC metastasis complained of more fatigue at the time of diagnosis than their counterparts without metastasis (31.0% vs. 5.8%, p = 0.002), but had less pronounced bowel habit change (38.0% vs. 65.4%, p = 0.017). Additionally, there were differences in histologic distributions of the tumors between patients with and without metastasis (p = 0.021). Conclusions: Compared with older CRC patients, younger CRC patients (<30 yr) have a higher frequency of mucinous adenocarcinomas, more aggressive diseases and poorer prognosis. Identification of clinicopathological characteristics in younger CRC patients would help diagnose and treat the disease in this unique group of CRC patients in the clinic.