Rectal carcinoma under 40 years of age: seven-year post-treatment follow-up at a tertiary care hospital in Pakistan

Objectives: to determine epidemiological characteristics, clinical presentation, histopathological features, and long-term follow-up of patients below 40 years of age with carcinoma rectum. methods: the retrospective case series comprised all patients presenting with histopathological diagnosis of carcinoma rectum with age 15-40 years at the aga khan university hospital between january 1994 and december 2004. details regarding patient demographics, pre-operative assessment, management and tumour grade and stage were obtained from a prospectively maintained database. continuous and categorical variables in the data were analysed. results: of the 23 patients in the study, 14 (60.89%) were male and 9 (39.13%) were female. mean age of the subjects was 31±5 years. overall, 22 (95.6%) patients presented with rectal bleeding and 12 (52%) had altered bowel habit. the most common site for the tumour was lower rectum (n=20; 87%) and 13 (56.5%) required abdominoperineal resection. local recurrence rate was 13% (n=3) and distant metastasis occurred in 2 (8.6%) patients during the seven year follow-up. two (8.6%) patients died, and both had distant metastasis. conclusion: carcinoma rectum is uncommon but an important malignancy in patients aged below 40 years. the clinician should have a high index of suspicion in young patients presenting with bleeding per rectum, altered bowel habit and weight-loss.