Coloreetal cancer in young patients, a five year experience

Abstract

BACKGROUND: Hereditary Non-Polyposis Colorectal Cancer (HNPCC) and Familial Adenomatous Polyposis (FAP) usually manifest in patients under 45 years of age. 70% of these tumours are found proximal to the splenic flexure and are associated with a high incidence of synchronous and metachronous lesions. OBJECTIVES: To ascertain if data available from western studies on young colorectal cancer patients corresponded with that of Sri Lankan patients and how many fulfilled the Amsterdam criteria for diagnosis of HNPCC. DESIGN AND SETTING: Retrospective study. Including all young colorectal cancer patients treated at the University Surgical Unit of the Teaching Hospital of North Colombo. RESULTS: The study included 28 patients (12 male and 16 females). The median age was 35 years (range 14-43). Five (18%) patients fulfilled 2 out of three of the Amsterdam criteria, while 20 (71%) fulfilled only one and 3 (11 %) fulfilled none. Significantly, 21 patients (75%) had lesions distal to the splenic flexure while only 7 (25%) had proximal disease. All underwent operative resection. Eight patients (29%) were alive at one year post operation, while 9 patients (32%) died within a year. Eleven patients (39%) were lost to follow up. CONCLUSION: Colorectal cancers in young Sri Lankan patients is predominantly a distal disease and does not fulfill the restrictive Amsterdam criteria for HNPCC.