Young patients with colorectal cancer at a tertiary hospital in Kenya, 1993-2005
H. Saidi, BSc., MBChB, MMed, FCS, Department of Human Anatomy, E.O. Nyaim, MBChB, MMed, FCS, D. Karuri, MBChB, J.W. Githaiga, MBChB, MMed, FCS, School of Medicine, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya.
Correspondence to: Dr. H. Saidi, Department of Human Anatomy, College of Health Sciences, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya. Email: firstname.lastname@example.org.
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Conflicts of Interest: None
BACKGROUND: The onset of colorectal cancer appears to be two to three decades earlier in developing countries. Data on whether colorectal cancer in the young has worse prognosis than in older patients is conflicting.
METHOD: Clinical charts of 70 patients ≤40 years old were reviewed to determine clinical and pathological patterns and treatment outcomes. Their data were compared with a larger group of older patients treated between 1993-2005 at Kenyatta National Hospital in Nairobi, Kenya.
RESULTS: The data retrieval was highest for sub-site distribution and lowest for pathology information. Patients ≤ 40 years of age comprised 27.3% of all colorectal cancer cases treated over the study period. There were 41 males (58.6%) and 29 (41.4%) females patients. The most common symptoms were abdominal pain (76.9%), change in bowel habit (71.4%) and rectal bleeding (54.3%). The mean duration of symptoms was 24.6 ± 30 months. The rate of advanced colorectal disease (Duke C and D) was 73.5%. Mean follow-up time was 5.8 months with median survival of only 6.9 months. The Duke staging, histology, symptom duration, locations of tumours, follow-up and the complication rates were similar for young and older patients.
CONCLUSION: Younger patients form a significant proportion of colorectal cancer burden. Both the clinico-pathological characteristics and treatment outcome correspond to older individuals. It is suggested that the concluded colorectal symptoms in younger patients should also be aggressively evaluated including early endoscopy. A prospective follow-up study of patients with the disease will unravel the true survival picture.