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Colorectal cancer in the young. Is it increasing?


Colorectal cancer in the young. Is it increasing?

Wednesday 8 May, 2013

The crude rate of colorectal cancer in young Australians is increasing, but this is in line with an overall increase in reported cases, delegates to the 82nd Annual Scientific Congress (ASC) of the Royal Australasian College of Surgeons have been told.

Mr Satish Warrier, a Consultant Surgeon in the Colorectal Surgical departments at Melbourne’s Alfred Hospital, Peter MacCallum Cancer Centre and Epworth Healthcare, noted that young onset colorectal cancer in the United States is increasing (You et al). He supervised Dr Chris Sia, an intern at the Alfred Hospital, to investigate similar trends in Victoria and determine if patients were presenting at more advanced stages of the disease.

The Victorian Cancer Registry, a state based database, was searched for those diagnosed with colorectal cancer at 18 years or older between 2000 and 2010. Site, grade, nodal status and survival were sought. Rates of metachronous colorectal cancer were calculated using participants up to 2005. Annual percentage changes were calculated using a joinpoint regression program, and comparisons between young and old cohorts were made.

“We identified 2635 patients aged below 50, representing 7% of all people diagnosed with colorectal cancer over the study period. Forty-seven were diagnosed between the ages of 45 and 49. The crude rate of young colorectal cancer increased at a rate of 1.7% per annum, compared with 1.3% for those aged over 50. While the incidence of older cohort was decreasing by 1.1% per annum, this trend was not noted in the young population. Sixty-three per cent of those with young colorectal cancer were reachable by sigmoidoscopy, compared with 53% of those with late onset cancer. Younger patients were more likely to have node positive disease, especially in the young colonic cancer group (49.3% vs 40%),” Dr Sia said.

“There has been an increase in reported cases of young colorectal cancer to the registry. No decrease in incidence in this cohort was observed. Young patients are more likely to have rectal cancers, and be node positive. Further follow up data is required for survival analysis.”

Approximately 1200 surgeons from New Zealand, Australia and around the world are attending the ASC, which runs from 6 to 10 May and is being held at Auckland’s Skycity/Crowne Plaza Convention Centre.


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