Aim: The aim of this study was to determine tumor characteristics and outcomes of patients
with rectal cancer <40 years old compared to those above that age at a single institution in
Background: The incidence of colorectal cancer is increasing in younger adults as observed from
limited available data from the Middle East.
Objective: Overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan-
Methods: We conducted a retrospective study of patients who were diagnosed with rectal cancer
over 15 years. Data were collected regarding demographics, stage, pathology, treatment, and outcomes.
Patients were stratified by age, with 40 years as cut-off. Descriptive statistics were conducted.
Results: Data for 105 cases were reviewed, 18 patients were aged under 40 years old and 87 patients
were above 40 years old. Younger patients had more poorly differentiated tumors than older
patients and were more likely to have tumors with signet-ring features. 5-year DFS was 35% and
51.5% for patients below and above 40 years old, respectively (P=0.04). OS was similar in the two
age groups, with a median follow-up of 36 months.
Conclusion: Further prospective studies with larger sample size and molecular markers are needed
to better understand the characteristics of rectal cancer in the young age group. With worse DFS in
our study and emerging evidence of a correlation between younger age at diagnosis and poor outcomes,
consideration should be given to more personalized upfront intensification of treatment in