Characteristics of Young Colorectal Cancer in Brunei Darussalam: an Epidemiologic Study of 29 Years (1986-2014)

Background: Colorectal cancer (CRC) is the most common gastrointestinal cancer and the incidence isincreasing. CRC is more common with increasing age, but a proportion occurs in young adults, termed youngCRC. This study assessed the incidence and the demographic of young CRC in Brunei Darussalam. Materialsand
Methods: All histologically proven CRC between 1986 and 2014 registered with the Department of Pathologycancer registry were reviewed and data extracted for analyses. Young CRC was defined as cancer in patientsaged less than 45 years. The various population groups were categorized into locals (Malays, Chinese andIndigenous) and expatriates.
Results: Over the study period, there were 1,126 histologically proven CRC (meanage 59.1 ± 14.7 years, Male 58.0%, Locals 91.8% and 8.2% expatriates). Young CRC accounted for 15.1% withthe proportion declining over the years, from 29% (1986-1990) to 13.2% (2011-2014). The proportion of youngCRC was highest among the indigenous (30.8%), followed by the expatriates (29.3%), Malays (14.3%) andlowest among the Chinese (10.8%). The mean age of young CRC was 35.9 ± 6.2; lowest among the indigenous(33.5 ± 6.7), expatriate (34.9 ± 6.0) groupd and the Malays (35.6 ± 6.5) compared to the Chinese (38.6 ± 4.6), asimilar trend being observed in the non-young CRC groups. There were no difference between the genders andtumor locations (rectum or colon) between the young and the non-young CRC cases. Female young CRC wassignificantly younger than male (p<0.05) without any significant variation between the various population groups(p>0.05).
Conclusions: Our study showed that the young CRC accounted for 15.1% of all CRC with decliningtrend observed over recent years. Young CRC was more common among indigenous, expatriates and Malaysand least common among the Chinese. There were no differences in the gender and tumor locations.