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Link Between Prolonged Rectal Bleeding and Young-Onset Colorectal Cancer?

By: Joseph Fanelli
Posted: Tuesday, September 3, 2019

According to findings presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago (Abstract 3576) and published in the Journal of Clinical Oncology, prolonged rectal bleeding may be an important identifying factor for earlier diagnosis and treatment in young-onset patients with colorectal cancer. Christopher Hanyoung Lieu, MD, of the University of Colorado Cancer Center, Aurora, and colleagues found that a significant portion of patients diagnosed with colorectal cancer before age 50 had demonstrated this symptom.

“Patients and primary care physicians should be made aware of this finding in order to facilitate timely referral for colonoscopy, which may lead to earlier diagnosis, less advanced disease at diagnosis, and improved outcomes,” the authors concluded.

In this study, the investigators collected patient data through the University of Colorado Cancer Center Cancer Registry. Those enrolled had colon or rectal cancer (42.1% had rectal cancer) and were younger than age 50 when diagnosed. The median age at diagnosis for the 211 patients chosen for review was 42.4 years.

The authors found that 52.2% of the patients had rectal bleeding prior to diagnosis. Of those patients, the average time from the start of the symptoms to diagnosis was 271.17 days, and 42.9% of those patients had stage IV colon or rectal cancer when initially diagnosed. An evaluation of the patient population pathology specimens found that 89.6% had adenocarcinomas and that 63.5% had grade 2 or higher disease.

Almost three-fourths of patients (72.5%) had a family history of any type of cancer. KRAS or NRAS mutations were detected in 49.6% of patients, BRAF V600E mutations were present in 3.8%, and microsatellite instability–high alterations were found in 10.8% of patients.

Disclosure: The study authors’ disclosure information may be found at coi.asco.org.



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