Young-onset colorectal cancer in the North East of Scotland: survival, clinico-pathological features and genetics

Abstract

Background: Colorectal cancer (CRC) in patients aged under 55 years is on the rise, constituting approximately 10% of cases. Our aim was to determine the survival and clinico-pathological details of young-onset CRC (yCRC), as well as audit the referral rate to genetic services and thus establish the incidence of inherited cancer syndromes. Methods: A retrospective case note review was conducted for patients aged under 55 years who were diagnosed with CRC between 2005 and 2015 in the North East of Scotland. Cases were identified by pathology records and data was obtained from patient notes. Analysis was performed using SPSS version 25 (IBM, New York, USA) to produce Kaplan-Meier survival estimates, descriptive statistics and markers predictive for genetic referral.Results: Data from 345 patients (age range 22-54 years) were identified. The one year, five year and overall survival rates were found to be 89, 63 and 55%, respectively. Most patients (61%) presented with advanced disease. Of 201 patients that met criteria for genetic referral, only 93 (46%) were referred to genetic services. Microsatellite instability (MSI) was identified in 14% of those referred. Conclusion: Survival in yCRC was found to be better than that in later onset disease, despite higher rates of advanced disease. Patients were under-referred to genetic services, where a significant proportion were found to be MSI positive and investigated for Lynch syndrome.

Colorectal Cancer in North-Eastern Iran: a retrospective, comparative study of early-onset and late-onset cases based on data from the Iranian hereditary colorectal cancer registry

“…The sample size of these studies ranged between 49 and 64,068 cases [ 5 , 7 – 18 , 48 , 56 – 58 ] and the mean age of study subjects ranged between 37 and 47 years [ 5 , 7 – 12 , 14 – 18 ]. In contrast to our study, the frequency of early-onset CRC is generally reported to be higher in men than in women [ 5 , 7 , 10 , 11 , 13 – 17 , 48 ], but various studies have yielded conflicting results [ 10 , 28 , 47 , 59 ]. Without finding any reason for the gender difference, we noted that early-onset CRC predominantly affected women, whereas late-onset CRC mainly involved men, which was statistically significant.…”

“…Furthermore, we found that more than 39% of our cases were first diagnosed with CRC when still under 50 years. We also found that the mean age for early-onset CRCs was 40 years and that the highest number of cases were in the final decade of the age range investigated (40–50 years of age), which is in accordance with other studies [ 9 , 11 , 16 , 48 ]. However, this pattern is more pronounced in Asia than in the Western countries [ 38 , 49 – 55 ].…”

Possible applications of salvianolic acid B against different cancers

“…Colorectal cancer is the third most death causing cancer worldwide [ 104 , 105 ]. In colorectal cancer patients, 5-year survival rate generally after diagnosis is around 50–55% [ 106 ]. Chemotherapy for colorectal cancer is the ideal choice of intervention but drug resistance often hampers the success of therapy.…”

Portrait of Cancer Stem Cells on Colorectal Cancer: Molecular Biomarkers, Signaling Pathways and miRNAome

“…The reduced cancer-mortality is attributable to population-based screenings and significant progresses in therapeutic options improving CRC patient’s management [ 2 ]. Approximately 10% of CRC patients under 55 years showed more severe and unfavorable pathological features than older cohorts, resulting in a negative impact on their survival outcome [ 3 ].…”