Colorectal cancer in the young adult

Out of 964 patients presenting with primary colorectal cancer (CRC) to the Department of Colorectal Surgery, Singapore General Hospital between April 1989 until December 1992, there were 57 (5.9%) aged 40 years or less. These younger patients were significantly more likely to have a family history of cancer particularly CRC; a tumour situated more proximally; and tumours displaying certain characteristic histopathologic features. There were no adverse findings for clinicopathologic staging at presentation, curative resection rate, and systemic recurrence rate within the early follow up period. With proper management, the young adult with CRC enjoys the same outlook as his older counterpart. But, in view of the likely operation of inherited genetic factors, follow up surveillance of the patient and the provision of advice and screening are vital elements in optimising outcome. Furthermore, advice and screening should be available for first degree relatives as well.