Background. Early onset colorectal carcinoma (CRC) is rare and has been hypothesized to be a biologically and clinically distinct entity personifying aggressive disease and worse survival. Methods. Data for 131 patients was collected by retrospective chart review. Cox proportional hazard model was used to compute prevalence ratios and 95% confidence intervals. Results. Early onset sporadic CRC accounted for 32% of all CRC treated in the specified time period. The mean age was years and the male to female ratio was . Colon and rectal cancers accounted for 55% and 45% of patients, respectively. 96% of rectal carcinoma patients received appropriate therapy as opposed to 65% of colon cancers. On multivariable analysis, appropriate reception of therapy (PR 4.99; 95% CI, 1.21–20.6) and signet ring morphology (PR 2.40; 95% CI, 1.33–4.32) were significantly associated with rectal cancers as opposed to colon cancer. Kaplan-Meier analysis revealed a trend towards inferior survival for rectal carcinoma 2 years after diagnosis. Conclusion.A high prevalence of early onset CRC was noted in the study. A trend towards inferior survival was seen in patients with rectal cancer. This finding raises the possibility of rectal carcinoma being an aggressive subset of young CRC. 1. Introduction Colorectal carcinoma (CRC) is one of the most common cancers diagnosed worldwide. It has been documented that CRC is the second most common malignancy in females and the third most common amongst males [1]. Epidemiological data suggests a higher incidence of sporadic CRC in developed countries, with Australia and New Zealand having an age adjusted incidence of 45.7 per 100,000 as compared to Southeast Asia which has a reported incidence of 15.9 per 100,000 [1]. Interestingly, a rapid increase in CRC incidence rate in economically transitioning countries has been recently reported in the literature [2] and has been attributed to a change in the dietary habits and physical activity patterns superimposed on genetic predisposition. Age is considered a major risk factor for colon cancer. Diagnosis of CRC is a rare occurrence in patients less than 40 years. Thereafter, the incidence increases sharply with every decade of life. In developed countries, the risk of colon cancer is 1 in 10 males after the 8th decade of life [3]. The life time risk of sporadic CRC is 5% and it accounts for 90% of the cases diagnosed in patients above 50 years [3]. Early onset CRC accounts for around 7% of the total CRC population in the West [4] but the problem has been reported to be of a much greater magnitude
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