Colorectal carcinoma in young females.
BACKGROUND
We sought to study the clinicopathologic characteristics of colorectal cancer in young female patients. We also wanted to determine the association of colorectal cancer with anemia in these female patients and, finally, to determine the effect of gender on prognosis in young patients with colorectal cancer.


METHODS
We performed a retrospective analysis of all young patients diagnosed with colorectal cancer between 1982 and 1999 in two teaching hospitals in New York City.


RESULTS
A total of 3,546 cases of colorectal cancer were diagnosed. Sixty-one (1.63%) of these patients were young patients and 32 (0.85%) were female. Young refers to all patients in the study who were younger than 40 years of age. The clinical presentation and mean age at presentation were very similar in both male and female patients. At presentation, 87.5% of female patients had anemia compared with only 69% of male patients. Males had a statistically significant higher mean hemoglobin level compared with females (12.87 versus 10.29 g) at P = 0.0001. Seventy-nine percent of female patients compared with 86% of male patients presented with left-sided tumors. Fifty-five percent of males presented with late stage disease compared with 68% of females (P = 0.27). Female sex seemed to adversely affect the prognosis, although this did not reach statistical significance (P = 0.08). Stage of disease was associated with worse prognosis and this was independent of sex. Age and hemoglobin were not independent predictors of mortality.


CONCLUSIONS
Colorectal cancer does occur in females of childbearing age who might have a tendency to present with late stage disease as evidence from this study. Young female patients with anemia should be questioned about gastrointestinal symptoms, and colorectal cancer should definitely be in the differential diagnoses. This might conceivably allow for earlier diagnosis and potential for cure in this patient group.
Olofinlade
Olusola
O
Section of Gastroenterology, Department of Medicine, St. Vincent's Hospital, New York, NY, USA. olusola_olofinlade@yahoo.com
Adeonigbagbe
Olusegun
O
Gualtieri
Nicholas
N
Freiman
Hal
H
Ogedegbe
Olugbenga
O
Robilotti
James
J
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000209:etiology; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009367:Neoplasm Staging; D016017:Odds Ratio; D012189:Retrospective Studies