Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;62(12):636-641.
doi: 10.11622/smedj.2021051. Epub 2021 May 19.

Clinicopathological patterns and survival outcomes of colorectal cancer among young adults in Malaysia: an institutional cohort study

Sui-Weng Wong  1 , Dao-Yao Ling  1 , Ri-Qi Yeow  1 , Ro-Wan Chong  1 , Mohamed Rezal Abdul Aziz  1 , Nora Abdul Aziz  1 , Keat-Seong Poh  1 , April Camilla Roslani  1
Affiliations

Clinicopathological patterns and survival outcomes of colorectal cancer among young adults in Malaysia: an institutional cohort study

Sui-Weng Wong et al. Singapore Med J. 2021 Dec.

Abstract

Introduction: This study aimed to investigate the clinicopathological patterns and survival outcomes of patients with young-onset colorectal cancer (CRC) in Malaysia.

Methods: A total of 206 patients with young-onset CRC (age < 50 years at diagnosis) and 1,715 patients with late-onset CRC (age ≥ 50 years at diagnosis) diagnosed during 2002-2016 were included. The clinicopathological characteristics of patients with young-onset CRC were compared with those of patients with late-onset CRC during 2009-2013. Kaplan-Meier survival analysis was performed to determine the overall survival (OS) and disease-specific survival (DSS) in these patients.

Results: The overall proportion of young-onset CRC was 10.7%. The mean age for young-onset CRC was 39.5 ± 7.4 years, with a male-to-female ratio of 1.2:1. There were more Malay patients with young-onset CRC than late-onset CRC (44.0% vs. 19.9%, p = 0.004). Most CRCs were diagnosed at an advanced stage in both groups. However, young-onset CRC showed more aggressive tumour characteristics, such as poorer differentiation and mucinous subtype. Despite such differences, the OS and DSS in both groups were similar (five-year OS for young-onset CRC vs. late-onset CRC: 44.2% vs. 49.0%, p = 0.40; five-year DSS for young-onset CRC vs. late-onset CRC: 48.8% vs. 57.6%, p = 0.53; mean survival of young-onset CRC vs. late-onset CRC: 4.9 years vs. 5.4 years, p = 0.15). Advanced stage at diagnosis and the treatment modality used were independent prognostic factors.

Conclusion: The unique ethnic and histological differences between patients with young- and late-onset CRC suggest that young-onset CRC may represent a distinct entity. However, despite such differences, both groups were equivalent.

Keywords: Malaysia; colorectal cancer; prognosis; survival rates; young adults.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Kaplan-Meier graphs show (a) OS in Stages I–III; (b) OS in Stage IV; (c) DSS in Stages I–III; and (d) DSS in Stage IV CRC. CRC: colorectal cancer; DSS: disease-specific survival; OS: overall survival
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Azizah Ab M, Nor Saleha IT, Noor Hashimah A, Asmah ZA, Mastulu W. Malaysian National Cancer Registry Report 2007-2011. Malaysia cancer statistics, data and figure. National Cancer Institute, Ministry of Health Malaysia. [Accessed August 1, 2019]. Available at: https://www.crc.gov.my/wp-content/uploads/documents/report/MNCRRrepor200... .
    1. Arnold M, Sierra MS, Laversanne M, et al. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66:683–91. - PubMed
    1. Center MM, Jemal A, Smith RA, Ward E. Worldwide variations in colorectal cancer. CA Cancer J Clin. 2009;59:366–78. - PubMed
    1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide:sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–86. - PubMed
    1. Siegel RL, Jemal A, Ward EM. Increase in incidence of colorectal cancer among young men and women in the United States. Cancer Epidemiol Biomarkers Prev. 2009;18:1695–8. - PubMed