Colonic and rectal carcinoma in patients less than 40 years of age is not rare. Indeed, these tumors are among the most common neoplasms seen in young adults.
Any young patient who has abdominal pain, rectal bleeding, or change in bowel habits should be evaluated with this in mind. The large number of right-sided colonic lesions in the young should encourage the use of barium-enema studies in addition to sigmoidoscopy to evaluate these cases.
Presenting symptoms may unfortunately be an indication of advanced disease. Although the low index of suspicion in this age group accounts for occasional delays, this was not a general feature and does not explain the poor results seen in these young patients.
We have found a large number of patients with anaplastic and mucinous carcinomas and a predominance of Dukes' C and D lesions. This more aggressive behavior of colorectal carcinoma in patients less than 40 years old seems to account for the poor prognosis seen.