Akademik Veri Yönetim Sistemi
United European Gastroenterology Week , Kobenhavn, Danimarka, 15 - 19 Ekim 2023, cilt.11, sa.58, ss.1116
PP1003
RISK FACTORS AND HISPATHOLOGICAL CHARACTERISTICS OF
EARLY-ONSET COLORECTAL CANCER
E.S. Koc1
, A. Tiftikçi2
, Ö. Er3
, A. Yazar3
, N.E. Kutsal2
, C. Aygün2
, S.
Göksel4
, A.S. Erdamar Çetin4
, N. Tözün2
1
Acibadem University School of Medicine, Internal Medicine,
Istanbul, Turkey, 2
Acibadem University School of Medicine,
Gastroenterology, Istanbul, Turkey, 3
Acibadem Univrsiry School of
Medicine, Oncology, Istanbul, Turkey, 4
Acibadem University School
of Medicine, Patology, Istanbul, Turkey
Contact E-Mail Address: elifskoc@gmail.com
Introduction: Colorectal cancer (CRC) is a global health problem with high
incidence and mortality rates. Although the incidence has decreased with
the use of screening tests, the mortality rate is approximately 1,6 – 2,0 %
per year. Recent studies have shown a steady increase in the incidence of
early onset (<50 years) CRC compared to that of patients >50 years of age.
Early-onset CRC cancer is reported to have a more progressive course and
may have a genetic and epigenetic background. In this study, we aimed
to investigate the disease characteristics and risk factors for colorectal
cancer in patients <50 years old and compare with patients over 50 years
of age.
Aims & Methods:Patients younger than 50 years, diagnosed with colorectal
adenocarcinoma and followed in our hospitals’ gastroenterology,
oncology, or general surgery departments between January/2009 and
June/2022 were included in this retrospective study. A total of 6102
patients’ files were examined. Among these, 1166 were under the age of
50, whilst 4936 were 50 years and older. Patients younger than 18 years,
who had a previous history of CRC, a known familial CRC syndrome, who
had synchronous tumors at the time of diagnosis or had in situ CRC were
not included in the study. After applying the exclusion criteria, 989 patients
were included in the under-50 age group. The comparison group consisted
of 1009 patients randomly selected from a group of 4000 patients aged 50
years or older. Patients were divided into Group A (<50 years) and Group
B (≥ 50 years) according to the age at diagnosis. Patients’ demographic
characteristics, body mass index, history of cigarette smoking and alcohol
use, presenting symptoms, history of H. pylori infection, co-morbidities
and medications were recorded from the files. Tumour characteristics,
localization, size, TNM stage, and treatment methods were also analyzed
and the relationship with each other was examined comparatively.
Results: The results of 1998 patients included in the study are shown in able 1. TNM stages and the duration of symptoms before the diagnosis were similar between the groups but the rate of stage 1 disease was higher in group B. The rates of metastatic disease and rectal cancer were higher in Group A, but statistically non-significant. Abdominal pain was significantly more frequent in Group A, while anemia was significantly more common in Group B. Patients in Group A had higher rates of IBD, family history of CRC, mucinous adenocarcinoma, poorly differentiated tumor, higher histological grade and higher microsatellite instability (MSI-H). Although perineural and lymphatic invasion rates were similar, vascular invasion was higher in group B.VariablesGroup A (n)Group B (n)p valueBody Mass Index ≥30 kg/m2110198p<0.01Family history of CRC137130p<0.05History of Inflammatory Bowel Disease167p<0.01Tumor grade-1104151p<0.01Mucinous adenocarcinoma13190p<0.01Poor differentiation16596p<0.01High histologic grade11665p<0.01Presence of vascular invasion277412p<0.01MSI-H5829p<0.01Table1. Comparison of Patients in Group A and Group BConclusion: Our study revealed that Early-onset CRC is more frequently diagnosed at the metastatic stage, is characterized by a more common presence of mucinous cells, poorly differentiated histology, and microsat-ellite instability.Disclosure: Nothing to disclose