Rectal cancer in patients under the age of 50 years: the delayed diagnosis

Scott, Robert G.; Rangel, Lynsey E.; Osler, Turner M.; Hyman, Neil

doi:10.1016/j.amjsurg.2015.08.031

Cited by 76 publications

(63 citation statements)

References 21 publications

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“…This cut‐off was determined using survival curves and is relevant as they also demonstrated that patients ≤35 years who were diagnosed with CRC had a worse prognosis due to a higher proportion of advanced stage tumours. 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 . Nonetheless, the overall increased rate of malignancy warrants early investigation for young patients presenting with any warning symptoms and our findings should promote increased awareness and the insistent search of symptoms in otherwise young, low‐risk patients.…”

Section: Discussionmentioning

confidence: 78%

Colorectal cancer in young patients: a retrospective cohort study in a single institution

Olivo¹,

Ratnayake²

2019

ANZ Journal of Surgery

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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.

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Section: Discussionmentioning

confidence: 78%

Colorectal cancer in young patients: a retrospective cohort study in a single institution

Olivo¹,

Ratnayake²

2019

ANZ Journal of Surgery

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“…One study indicated that the median time to initial clinical presentation after the onset of symptoms was twice as long for patients with early‐onset CRC compared with older patients (60 days vs 30 days), and that patients with early‐onset CRC experienced a longer time to diagnosis after symptom recognition (128 days vs 79 days) . A study of patients with rectal cancer indicated that the time from symptom onset to treatment was more than 4 times longer for patients younger than 50 years (217 days) compared with adults aged 50 years and older (58 days) . This delay may be caused by failure on the part of both patients and primary care clinicians to consider CRC as a potential cause of symptoms, resulting in a less aggressive diagnostic approach than that taken in older individuals who present with similar symptoms.…”

Section: Screening and Surveillance For The Early Detection Of Adenommentioning

confidence: 99%

Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening

Smith

Andrews

Brooks

et al. 2019

CA A Cancer J Clinicians

482

341

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Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the current American Cancer Society cancer screening guidelines are summarized, and the most current data from the National Health Interview Survey are provided on the utilization of cancer screening for men and women and on the adherence of men and women to multiple recommended screening tests.

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“…One study found that the median time for initial clinical presentation after the onset of symptoms was twice as long for patients with young‐onset CRC compared with older patients (60 days vs 30 days) and that patients with young‐onset CRC experienced a longer time to diagnosis after symptom recognition (128 days vs 79 days) . A study of patients with rectal cancer found that the time from symptom onset to treatment was more than 4 times longer for patients younger than 50 years (217 days) compared with adults aged 50 years and older (58 days) . This delay may be because of failure on the part of both patients and primary care clinicians to consider CRC as a potential cause of symptoms, resulting in a less aggressive diagnostic approach than that taken in older individuals who present with similar symptoms.…”

Section: Screening and Surveillance For The Early Detection Of Adenommentioning

confidence: 99%

“…59 A study of patients with rectal cancer found that the time from symptom onset to treatment was more than 4 times longer for patients younger than 50 years (217 days) compared with adults aged 50 years and older (58 days). 60 This delay may be because of failure on the part of both patients and primary care clinicians to consider CRC as a potential cause of symptoms, resulting in a less aggressive diagnostic approach than that taken in older individuals who present with similar symptoms. Young individuals are also more likely than older patients to be diagnosed with distant versus localized stage CRC.…”

Section: Crc Trends In Younger Individualsmentioning

confidence: 99%

Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening

Smith

Andrews

Brooks

et al. 2018

CA A Cancer J Clinicians

420

297

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Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates from the National Health Interview Survey, and select issues related to cancer screening. In this 2018 update, we also summarize the new American Cancer Society colorectal cancer screening guideline and include a clarification in the language of the 2013 lung cancer screening guideline. CA Cancer J Clin 2018;68:297-316. © 2018 American Cancer Society.

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Rectal cancer in patients under the age of 50 years: the delayed diagnosis

Cited by 76 publications

References 21 publications

Colorectal cancer in young patients: a retrospective cohort study in a single institution

Colorectal cancer in young patients: a retrospective cohort study in a single institution

Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening

Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening

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