Delayed Diagnosis in Teenage Colorectal Cancer Cases
A study examining colorectal cancer in young people, presented at the American Academy of Pediatrics conference in San Diego, revealed that most cases in patients aged 21 or younger were identified at later stages. Researchers analyzed data from 84 children and adolescents, noting an average delay of 12 weeks from symptom onset to diagnosis, with 80% presenting with stage III or IV disease upon detection.
Researchers noted high rates of aggressive tumor biology in these cases, including signet ring features, mucin, and poorly differentiated histology. These features appeared more frequently than what is typically seen in adult colorectal cancer, suggesting the disease behaves differently in this young age group. The study authors suggested that this distinct biology may contribute to the poor outcomes observed in the cohort.
Dr. Erica Arnold of Nationwide Children’s Hospital in Columbus, Ohio, explained that the advanced stage at diagnosis creates significant challenges for treatment. The combination of late presentation and aggressive tumor characteristics makes successful outcomes difficult to achieve.
Dr. Danielle Cameron of the Mass General Brigham Cancer Institute in Boston pointed out the diagnostic dilemma. She noted that screening every teenager who experiences abdominal pain would lead to overtesting and overtreatment of common, benign conditions. Instead, she emphasized the need for a high level of suspicion among clinicians.
Cameron added that there are specific considerations for rare solid tumors that may more commonly appear in the adult population or vice versa. In a 20-some-year-old, we may see a more classic pediatric solid tumor. And so whenever you’re encountered with an adolescent or college-age patient, remembering that they may not fit the usual box is really important and critical for figuring out who to refer to and what diagnoses to consider.
