Clinical, Endoscopic and Pathogical Characteristics of Early-Onset Colorectal Cancer in Vietnamese

Background: The Asia Pacific consensus for colorectal cancer (CRC) recommends that screening programsshould begin by the age of 50. However, there have been reports about increasing incidence of CRC at a youngerage (i.e. early-onset CRC). Little is known about the features of early-onset CRC in the Vietnamese population.Aim: To describe the clinical, endoscopic and pathological characteristics of early-onset CRC in Vietnamese.
Method: A prospective, cross-sectional study was conducted at the University Medical Center from March2009 to March 2011. All patients with definite pathological diagnosis of CRC were recruited. The early-onsetCRC group were analyzed in comparison with the late-onset (i.e. ≥ 50-year-old) CRC group.
Results: The rateof early-onset CRC was 28% (112/400) with a male-to-female ratio of 1.3. Some 22.3% (25/112) of the patientsonly experienced abdominal pain and/or change in bowel habit without alarming symptoms, 42.9% (48/112)considering their symptoms intermittent. The rate of familial history of CRC in early-onset group was significantlyhigher that of the late-onset group (21.4% versus 7.6%, p<0.001). The distribution of CRC lesions in rectum,distal and proximal colon were 51.8% (58/112), 26.8% (30/112) and 21.4% (24/112), respectively; which was notdifferent from that in the late-onset group (χ2, p = 0.29). The rates for poorly differentiated tumors were also notsignificantly different between the two groups: 12.4% (14/112) versus 8.3% (24/288) (χ2, p = 0.25).
Conclusion:A high proportion of CRC in Viet Nam appear at an earlier age than that recommended for screening by theAsia Pacific consensus. Family history was a risk factor of early-onset CRC. Diagnosis of early-onset CRC needsmore attention because of the lack of alarming symptoms and their intermittent patterns as described by thepatients.