Clinicopathologic Characteristics Of Colorectal Carcinoma In Young Female Patients

Background Colorectal cancer (CRC) is generally considered as a disease of elderpersons. However, a significant proportion of patients (<40 years) present with CRC. Many investigators have published data on CRC in young patients, yet the early diagnosis of CRC in young patients remains unsatisfactory. We aimed to summarize the recent epidemiological data of CRC and find out the specific clinicopathologic characteristics of young female CRC patients.Methods A total of 1496 CRC patients, including 112 cases of young CRC patients (<40 years) and 1384 cases of elder patients. (≥40 years), were involved in this retrospective study. All cases were diagnosed in the 2nd Affiliated Hospital of Zhejiang University. Comparative analyses are focus on the clinical and histopathologic data of young female CRC patients (55 cases) and elder female patients, such as colonscopic and histopathologic findings.Results Female CRC patients accounts for 49.1% in the young CRC population,compared with 39.6% in elder CRC population. Common clinical manifestations among young female CRC patients are hematochezia (65% cases), abdominal pain (29% cases), change in bowel habits including diarrhea (33% cases) and constipation (15%). Primary diagnosis of colorectal cancer was not decided in 36% (20 cases) of those young female CRC patients during their first diagnosis. CRCs were located in ascending (cecum, ascending colon, hepatic flexure) and transverse colon (25%), descending colon (27%) and rectum(52%) respectively. 48% of those CRCs were Borrmann III type, followed by II type (33%), I type (14%) and IV type (5%), with a frequent size of 4～8cm.Young female CRC patients has a higher rate of lymph node metastasis (64% vs. 50%), a later cancer staging (III and IV types, 71% vs. 53%), and a higher signet ring cell cancer rate (10% vs. 1%) although having a 65% portion of histological well-differentiated tumor, comparing with elder female CRC patients.Conclusions Female patients has a higher proportion in young CRC cases, usuallysent to the doctors due to bloody stool and diarrhea, with a late stage. Young female CRC patients has a higher rate of lymph node metastasis, a later cancer staging and a worse histological differentiation, comparing with elder female CRC patients. These findings emphasize the need for health care providers to have a heightened awareness when caring for this young population, particularly because excellent modalities exist to early diagnose and treat colorectal cancer.