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Incidence, clinical features and possible etiology of early onset (≤40 years) colorectal neoplasms

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Abstract

The aim of the study was to investigate the clinical features, including survival, of patients with colorectal malignancies developed at a very early age (≤40 years), together with possible factors involved in the pathogenesis of these rare neoplasms. The study took advantage of the existence of a specialized colorectal cancer Registry active from 1984. 57 patients met the criteria of early onset cancer; main epidemiological data, morphology, stage, familial aggregation, possible role of inheritance and survival were analyzed. Despite the relevant increase over time of all registered patients, joiningpoint analysis of crude incidence rate of early onset colorectal neoplasms revealed a certain stability of these tumors (EAPC: 2.4, CI 14–22) with a constant prevalence of the male sex. Stage at diagnosis did not show significant variations between early onset and maturity onset colorectal neoplasms. Hereditary as well as familial cases were significantly (P < 0.005 and 0.03) more frequent among patients with early onset tumors, although in the majority of them no specific etiological factor could be identified. Survival was more favorable in patients with early onset tumors, though this had to be attributed to the higher presence of some histological types in early onset cases. Survival was significantly more favorable for patients of all ages registered in the last decade. Incidence of early onset colorectal cancer was relatively stable between 1984 and 2008. A male preponderance was evident through the registration period. Hereditary and familial cases were significantly more frequent among early onset case. A well defined etiology could be observed in 16 % of the cases (versus 2–3 % in older individuals). Five-year survival showed a significant improvement over time.

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Acknowledgments

This work has been carried out with the financial support of AIRC (Associazione Italiana Ricerca Cancro). Francesco Mariani was supported by a grant from Fondazione Umberto Veronesi. Thanks are also due to the Regione Emilia Romagna and to the Fondazione Cassa di Risparmio (Modena) for generous support. ALTEG (fondata da G. Ratti). Parts of this work have been presented at the X° meeting of AIFEG (Italian Association for the studies of Hereditary Tumors), Padova 8–9 October 2012. This work has been presented at the XVII meeting of AIRTUM (Italian Association Registers of Tumors), Bolzano 20-22 Mar 2013.

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Authors and Affiliations

  1. Dipartimento di Medicina Diagnostica, Clinica e Sanità Pubblica, Università di Modena e Reggio, Emilia, Italy

    Federica Domati, Stefania Maffei, Shaniko Kaleci, Monica Pedroni, Luca Roncucci, Piero Benatti, Giulia Magnani, Luigi Marcheselli, Francesco Mariani & Maurizio Ponz de Leon

  2. Divisione di Anatomia Patologica, Policlinico, Modena, Italy

    Carmela Di Gregorio & Luca Reggiani Bonetti

  3. ALTEG Associazione per la Lotta ai Tumori dell’Età Giovanile, Rome, Italy

    Antonio Maria Alberti & Valerio Rossi

  4. Department of Diagnostic Medicine, Clinical and Public Health Medicine I, Policlinico, Via del Pozzo 71, 41100, Modena, Italy

    Maurizio Ponz de Leon

Authors
  1. Federica Domati
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  2. Stefania Maffei
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  3. Shaniko Kaleci
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  4. Carmela Di Gregorio
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  5. Monica Pedroni
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  6. Luca Roncucci
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  7. Piero Benatti
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  8. Giulia Magnani
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  9. Luigi Marcheselli
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  10. Luca Reggiani Bonetti
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  11. Francesco Mariani
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  13. Valerio Rossi
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  14. Maurizio Ponz de Leon
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Correspondence to Maurizio Ponz de Leon.

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Domati, F., Maffei, S., Kaleci, S. et al. Incidence, clinical features and possible etiology of early onset (≤40 years) colorectal neoplasms. Intern Emerg Med 9, 623–631 (2014). https://doi.org/10.1007/s11739-013-0981-3

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  • DOI: https://doi.org/10.1007/s11739-013-0981-3

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