title: Do young patients have different clinical presentation of colorectal cancer causing delay in diagnosis?
abstract: OBJECTIVE
  The incidence of colorectal cancer is increasing among young patients. In these patients, colorectal cancer is believed to have a poorer prognosis because it is more aggressive and diagnosed at later stages; however, the behavior of these tumors in young patients remains to be elucidated. We investigated the impact of time interval between onset of symptoms and diagnosis (TISD) at the pathologic stage of colorectal cancer in young patients.
  
  
  METHODS
  The medical records of 215 patients with colorectal adenocarcinoma were reviewed. Patients were divided into two groups according to age. The young group (age < 50 years) consisted of 66 patients, and the older group (age ≥ 50 years) of 149 patients. Clinical variables, TISD, pathologic stage, operative mortality, and oncologic outcomes were compared between groups.
  
  
  RESULTS
  The older group had less abdominal pain (74.0 vs. 56.0 %, p = 0.0129). In multivariate analysis, the following variables were independently associated with tumor pathologic stage: personal history of inflammatory bowel disease (p < 0.0001), family history of familial adenomatous polyposis (p = 0.00100), and smoking (p = 0.0070). Both groups had similar rates regarding pathologic stage (I, 15 vs. 22 %; II, 22 vs. 24 %; III, 27 vs. 16 %; IV, 37 vs. 38 %, p = 0.3380). There was no difference in overall survival [45 (69 %) vs. 84 (61 %), p = 0.2482] and cancer-free survival [36 (63 %) vs. 83 (62 %), p = 0.9218] between groups.
  
  
  CONCLUSIONS
  Young patients with colorectal cancer had clinical and pathological presentation similar to that of older patients.
authors.affiliation: Coloproctology Service, Hospital Universitário de Brasília, Universidade de Brasília, Center of Surgical Clinics, SGAN-Av. L2 Norte 604/605, Asa Norte, CEP: 70840-901, Brasília, DF, Brazil, sousajb@unb.br.
authors.forename: João Batista
authors.initials: JB
authors.lastname: de Sousa
authors.forename: Caio Simões
authors.initials: CS
authors.lastname: Souza
authors.forename: Maria Bianca
authors.initials: MB
authors.lastname: Fernandes
authors.forename: Leonardo
authors.initials: L
authors.lastname: de Castro Durães
authors.forename: Romulo Medeiros
authors.initials: RM
authors.lastname: de Almeida
authors.forename: Antônio Carlos Nóbrega
authors.initials: AC
authors.lastname: Dos Santos
authors.forename: Eduardo Freitas
authors.initials: EF
authors.lastname: da Silva
authors.forename: Paulo Gonçalves
authors.initials: PG
authors.lastname: de Oliveira
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000230:Adenocarcinoma / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000628:therapy; D057210:Delayed Diagnosis; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D015431:Weight Loss