Background: Colorectal cancer (CRC) in young adults is low, but for unclear reasons, a rise in CRC incidence has been reported in patients aged <50 years. The incidence of CRC in young individuals has increased by 2% to 8% annually over the past two decades. CRC diagnosis in young people is always difficult, early detection of colorectal cancer is important for early diagnosis and improve clinical management.
Case Description: Twenty four-year-old woman presented with symptoms of abdominal pain and vomiting for 5 months and weight loss. Thirty three-year-old man was hospitalized due to the symptoms of persistent abdominal pain for 5 months, fecal changes, bloody stools and weight loss. Both of them have no chronic disease or familial history of malignancy. The woman underwent an ileostomy and adhesiolysis through laparotomy due to a history of previous appendicitis. Intraoperative, colon was found dilated starting from the duodenum up to 10 cm proximal to the transverse colon so an extended right hemicolectomy is performed. The man underwent colostomy and Hartmann's procedure by laparotomy but the mass was failed to resected and followed by receiving adjuvant chemotherapy. Pathological finding post operative confirmed adenocarcinoma colorectal invasive for the woman and adenocarcinoma rectosigmoid for the man.
Conclusion: Within a young group, CRC is usually diagnosed later and potentially associated with worst prognosis. Detecting CRC at an early, more treatable stage is important for cure and survival. This report suggest a greater suspicion rate and early screening that necessary when evaluating young patients with common symptoms.