N05: Exogenous And Endogenous Associated Factors To Early Onset Colorectal Cancer

R. Zuppardo1, M. Di Leo2, A. Mannucci1, F. Azzolini1, D. Esposito1, Fanti1, G. Mazzoleni1, C. Notaristefano1, E. Viale1, R. Rosati3, P. Testoni1, G. M. Cavestro1

1 – Gastroenterology and Gastrointestinal Endoscopy, Division of Experimental Oncology, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy. 2 – Humanitas Clinical and Research Center, Department of Biomedical Sciences, Humanitas University, Milan, Italy. 3 – Department of Gastrointestinal Surgery, San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy


Aim: Early onset colorectal cancers (eoCRC < 50 years), is projected to increase by as much as 90% and 140%, respectively by 2030, and germline mutations appear to account for only about 20%. We investigate the role of exogenous and endogenous risk factors as associated factors in eoCRCs.

Method: Clinical, anamnestic and pathological data were retrieved on eoCRC patients from 06/2017 to 04/2018, and compared with a group of late onset CRC (loCRC) of the same period.

Results: We enrolled 33 eoCRCs and 48 loCRCs, mean age 40.7 +/- 7.3 and 66.1 +/- 9.8, respectively (p<0.001), prevalence of females (54.5% in eoCRCs and 52.1% in loCRCs). Diagnostic delay was higher in eoCRC group: 42.4% of eoCRCs diagnosed in the 6th months from symptoms onset versus 100% of loCRC patients (p<0.001). Lynch syndrome was more frequent in eoCRC (12%) than loCRC group (0%) p=0.02. A statistically significant difference was found in alcohol habit, 66.7% of no-drinker in eoCRCs and 41.7% of loCRCs (p=0.04), and a trend through significance for no-smokers in eoCRCs.

Conclusion: CRC should be considered earlier for differential diagnosis in young patients. We confirmed alcohol as cofactor in development of eoCRC and we underlined that familiar history should be collected to identify mutations carriers.