Epidemiología del cáncer colorrectal en menores de 50 años en el Hospital Juárez de México

Introduction

Colorectal cancer (CCR) is the third most common, and the third leading cause, of cancer death in men and women in the United States, and accounts for 2.68% of all malignant tumours in Mexico. CCR was considered as a disease of older adults, but a progressive and significant increase has been observed in the detection of CCR in younger people. Colonoscopy is the diagnostic method of choice, with a sensitivity and specificity of 98.2%.

Objective

To describe the epidemiological and histopathological characteristics of patients younger than 50 years old diagnosed with colorectal cancer in the Juarez Hospital of Mexico from January 2008 to January 2015.

Material and methods

Retrospective and descriptive study.

Inclusion criteria

Patients under 50 years old who underwent colonoscopy and colon cancer was documented with confirmatory histological study.

Exclusion criteria

Patients with a negative pathology result for colon cancer, and followed-up by other health institutions.

Elimination criteria

Patients with incomplete medical record or no record was found in clinical file. The analysis of results was with basic descriptive statistics and SPSS software 2012.

Results

In the specified period of study, there were 2,197 colonoscopies, with 101 patients under 50 years and 614 patients older than 50 years confirmed with colon cancer by histology. Of the patients younger than 50 years, only 86 were included for analysis (15 were patients with incomplete file). The study included 46 (53.5%) men and 40 (46.5%) women, with a mean age of 41.63 years (range 19-49 years). Elective colonoscopy was performed in 83 (96.51%) and 3 (3.4%) were urgent. The most common symptom was abdominal pain in 62.8%, and weight loss, rectal bleeding and constipation in 41.9, 29, and 24.4%, respectively. The time of onset of symptoms ranged from 1one month to 3 years, appearing in most cases the fourth month (21%). Location: ascending colon (27.9%), descending colon (26.7%), sigmoid (13.95%), rectum (12.79%), blind (9.3%), and transverse (5.8%). Surgical treatment was performed in 83 (98.5%) and palliative care in 3 patients (3.48%). The most frequent endoscopic finding was neoplasm associated with partial stenosis (100%). The correlation between the endoscopic and histopathological diagnosis of the surgical specimen report was 100%. The histological type: moderately differentiated adenocarcinoma 50 (58.1%). There were 24 (27.9%) cases in clinical stage IIA, with 22 (25.58%) in stage IIB, and 10 (11.62%) in stage IIIA. The mortality associated with colon cancer was 23 (26.70%; 12 men, women 11 women).

Conclusions

Colorectal cancer in adults under 50 years in the Juarez Hospital in Mexico is similar to that reported in the literature. It predominates in the male gender, is more common in the right colon, with an increased tendency to stenosis, and adenocarcinoma as histological type and stage clinical IIA.