Colorectal Carcinoma in the Young

Colorectal cancer (CRC) is the most common malignancy of the gastrointestinal tract. In the United States, it is the third most commonly diagnosed cancer, next only to breast and lung. It is the second most common cause of cancer-related death both in the USA and in the UK. (www. cancer. org, O’Connell et. al. 2004a, Leff et. al. 2007). Its incidence has risen rapidly in Asia to pose a problem (Yuen et. al. 1997, Huang et. al. 1999, Mohandas et. al. 1999, Yiu et. al. 2004, Goh et. al. 2005,Gupta et. al. 2010). Sung et. al. (2005) in a review on CRC in Asia stated that many Asian countries, e. g., China, Japan, South Korea, Singapore have experienced an increase of two to four times in CRC incidence during the past few decades. In Hong-Kong CRC is the second most common cancer and the third most common cause of cancer death (Yuen et. al. 1997). Tamura et. al. (1996) in a Japanese study reported that age adjusted incidence for CRC per 100,000 population were 12. 6 and 8. 7 for males and females respectively in 1974, 20 and 13. 6 in 1980, 42. 5 and 25. 6 in 1991. Bae et. al. (2002) estimated on the basis of Korean data, that the expected number of cancer deaths in Korea showed an increasing trend for CRC, although the same did not hold for all cancers. In Iran, age adjusted CRC incidence per 100,000 population per year increased from 1. 61 in 1970-80 to 4. 2 in 19902000 in men and 2. 35 to 2. 72 for women (Hosseini et. al. 2004). The rising trend is more striking in affluent than in poorer societies and differs substantially amongst ethnic groups. Changes in dietary habits and lifestyle are recognized causes. Genetic characteristics of a population mediate the effect of life style change into disease propensity (Lin et. al. 2010). Although the common perception is that it is a disease of an older person, there have been many reports from different parts of the world on CRC in the young adults (Bulow 1980, Denmark; Ohman 1982, Sweden;Jarvinen and Turunen 1984, Finland; Ibrahim and Karim 1986, Lebanon; Adloff et. al. 1986, France; Isbister and Fraser 1990, New Zealand; Yuen et. al. 1997, Hong-Kong; Fante et. al. 1997, Italy; Ashenafi 2000, Ethiopia; deSilva et. al. 2000, Srilanka; Paraf and Jothy 2000, Canada; Turkiewicz et. al. , 2001, Australia; Singh et. al. 2002a, Nepal; Kam et. al. 2004, Malayasia; Frizis et. al. 2004, Greece; Guraya and Eltinay2006, Saudi Arabia; Fazeli et. al. 2007, Iran; Karsten et. al. 2008, USA; Gupta et. al. 2010, India). O’Connell et. al. (2004a) have reviewed the literature. The proportion of patients in the young group in a population of CRC patients was significantly larger in reports from Asia and Africa, as compared to the Western reports.