A recent analysis of data from the Surveillance, Epidemiology, and End Results (SEER) registry showed that 1 of every 7 patients with colorectal cancer was younger than 50 years at diagnosis and were more likely to have advanced-stage disease at diagnosis.
The findings, published online ahead of print in the journal Cancer (doi:10.1002/cncr.29716), introduce questions regarding risk of developing colorectal cancer for younger adults, and whether screening recommendations should be expanded to include these patients.1
Current US recommendations are to begin screening at age 50 years. A team of researchers from the University of Michigan conducted a population-based retrospective study of SEER data on patients with colorectal cancer diagnoses in the United States from 1998 to 2011 to assess the treatment patterns and outcomes for these patients.
Of 258 024 patients with colorectal cancer, 37 847 (nearly 15%) were younger than 50 years. Younger patients with distant metastasis were more likely to undergo surgical therapy for their primary tumor (72% vs 63% of older patients); younger patients with rectal cancer were more often treated with radiation therapy than were older patients with the disease (53% vs 48%).
Overall, patients with colorectal cancer who were younger than 50 years at diagnosis tended to have more advanced disease, received more aggressive therapy, and lived slightly longer without a cancer recurrence.
The 5-year cancer-specific survival for patients younger than 50 years was 95.1% vs 91.9% for patients 50 years and older for localized disease, 76% vs 70.3% for regional disease, and 21.3% vs 14.1% for distant disease, respectively.
The researchers recommend clinicians and patients look for warning signs of colorectal cancer such as anemia, a dramatic change in the size or frequency of bowel movements, and dark blood or blood mixed with the stool in bowel movements.
In addition, people with a positive family history for colorectal cancer (first-degree relatives such as parents or siblings with the disease) and those persons at higher risk should begin screening earlier than age 50 years.
1. Wiley. Many colorectal cancer patients are younger than the recommended screening age [news release]. EurekAlert! Web site. http://www.eurekalert.org/pub_releases/2016-01/w-mcc012016.php. Posted January 25, 2016. Accessed January 25, 2016.