Colorectal adenocarcinoma in young Lebanese adults. The American University of Beirut-Medical Center experience with 32 patients.

Colorectal adenocarcinoma is uncommon in Lebanon. The low frequency and the low average age at the time of diagnosis, 53.7 years, is similar to that observed in other developing countries. Over a period of 40 years (1945-1985), 32 patients (5.8%) developed colorectal adenocarcinoma before age 30 years. Seventeen and 15 patients were males and females, respectively (age range, 14-29 years). The most common presenting symptoms were blood per rectum (27 patients) and abdominal pain (23 patients). The average interval from the first symptom to histologic diagnosis was 5.7 months. The only significant predisposing factors were the presence of a positive family history for colorectal carcinoma in one patient and bladder exstrophy with ureteral diversion in another. Twenty-four patients had surgery with curative intent. Colloid and signet ring adenocarcinoma were present in 22 patients (68.7%). Classification by Duke's staging system demonstrated Stage C in 15 and Stage D in 5 patients. These findings show a definite increase in carcinoma with high histologic grade and advanced stage at presentation in young Lebanese patients.