title: Advanced colon cancer before the age of 20 years: a case for extension of the current colonoscopy surveillance guidelines in hereditary nonpolyposis colorectal cancer syndrome.
abstract: BACKGROUND
  Hereditary nonpolyposis colorectal cancer (HNPCC) currently accounts for between 2% to 6% of all colorectal adenocarcinomas. Controversies exist regarding the current guidelines for colonoscopic screening for colon cancer.
  
  
  METHODS
  A case of colon cancer in a young Japanese man with a family history of colon cancer that did not meet the criteria for HNPCC is reported. A malignant pelvic mass discovered shortly before his 20th birthday prompted a colonoscopy. The findings at colonoscopy determined that the patient and his family fulfilled the criteria of HNPCC.
  
  
  CONCLUSIONS
  Before finding a pelvic mass metastatic from adenocarcinoma of the ascending colon, this patient was clearly outside of the current guidelines for HNPCC screening. It is suggested that in similar patients, even if they do not fulfill all the criteria for HNPCC, it would be appropriate to consider screening well before the recommended lower age.
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Victor K
authors.initials: VK
authors.lastname: Wong
authors.forename: Eric M
authors.initials: EM
authors.lastname: Yoshida
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Ryan
authors.forename: Stephen G F
authors.initials: SG
authors.lastname: Ho
authors.forename: Baljinder
authors.initials: B
authors.lastname: Salh
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics; D000328:Adult; D017668:Age of Onset; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000235:genetics; D003113:Colonoscopy; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic