CHICAGO (February 21, 2020): Colon cancer is more likely to be lethal in children and young adults than middle-aged adults. In a single-institution study, researchers at The University of Texas MD Anderson Cancer Center, Houston, Tex., found that differences in mortality rates persist regardless of whether pediatric, adolescent, and young adult patients (aged 24 and younger) were born with a predisposition for colon abnormalities or disease and for the first time conclude that young people are more likely to have metastases outside the colon, into the abdominal cavity, when they are diagnosed. Their findings put families, clinicians, and surgeons on alert to be sure abdominal complaints in young people are thoroughly and carefully evaluated when first reported, and aggressively treated if cancer is discovered. Study findings appears in an "article in press" on the Journal of the American College of Surgeons website in advance of print.

Colon cancer is rare in individuals under age 25. Prevalence of the disease in patients under age 20 is 0.2 percent. While the Surveillance, Epidemiology and End Results Program (SEER) estimates more than 145,000 new cases of colon cancer for 2019, only about 290 cases are expected in children and young adult people.1

The diagnosis of colon cancer in children, and young adults is often delayed. Most (70 percent) children and young adult patients in a 2019 survey by Colorectal Cancer Alliance were diagnosed with stage 3 or stage 4 disease. In contrast, older patients are more likely to be diagnosed with stage 1 or 2 disease.2
"Children with colon cancer can fall through the cracks. They may be seen by an oncologist who treats adults but who doesn't know how to treat children. Or they may be seen by a pediatrician who knows all about treating children but nothing about colon cancer," said Andrea Hayes-Jordan, MD, FACS, lead author of the paper, and Surgeon-in-Chief of the North Carolina Children's Hospital, University of North Carolina, Chapel Hill. She was a professor and section chief of pediatric surgery at MD Anderson at the time the study was conducted.

The result is no clear path for treating children with colon cancer, other than providing the same treatment as adults. Furthermore, study findings clearly show that these types of interventions are not effective. "Stage for stage, children fare 5 to 6 times worse with treatment. So a child with Stage 4 disease has a 6 times higher chance of dying than an adult with the same stage of cancer," Dr. Hayes-Jordan said.

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