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Title: Managing young colorectal cancer: a UK and Irish perspective.
Epworth Authors: Warrier, Satish
Lynch, A. Craig
Heriot, Alexander
Other Authors: Yeung, Justin
Keywords: Colorectal Cancer
Patient Care Management
Colorectal Neoplasms, Hereditary Nonpolyposis
Lynch Syndrome
Department of Surgery, Epworth HealthCare, Richmond, Victoria, Australia
Issue Date: Feb-2014
Citation: (2014) 38:1827–1833
Abstract: Objective: Young patients with familial syndromes have an increased metachronous colectomy. The study surveys the Association of Coloproctology of Great Britain and Ireland (ACPGBI) membership preoperative evaluation and clinical management in young patients with colorectal cancer (CRC). Method: An electronic survey was sent to the membership of the ACPGBI. The survey polled members on clinical scenarios relating to young-onset CRC patients. We were particularly concerned with preoperative management strategies, the extent of colectomy, and postoperative surveillance. Survey responses were collated and analysed. Results: A total of 124 members responded to the survey and 74 completed the survey. Of these, 87.8 % would proceed to colectomy without preoperative tumor or genetic testing. Decisions regarding the extent of olectomy depended on family history. A total of 67 (90.6 %) would offer a limited colectomy with no family history, 49 (66.2 %) in a patient with familial CRC type X, 29 (39.2 %) in a young patient with Lynch syndrome. A similar trend was seen with young rectal cancer. Only 16 surgeons (21.6 %) could identify a syndrome of MYH-associated polyposis (MAP). Conclusion: The majority of ACPGBI members will not offer preoperative risk testing based on a young age alone; however, the majority would alter their surgical strategy based on the results of this testing. MAP is poorly recognized by ACPGBI members and therefore an opportunity exists for education among members. What is new in this paper? This study is the first paper to survey the ACPGBI membership on management practices in young-onset CRC. Members are poor in adopting preoperative testing, alter surgical strategy based on a familial syndrome, with a minority recognizing MAP. An opportunity to improve education on young CRC patients exists.
DOI: 10.1007/s00268-014-2470-x
PubMed URL:
ISSN: 0364-2313
Journal Title: World Journal of Surgery
Type: Journal Article
Affiliated Organisations: Division of Cancer Surgery, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia
Department of Surgical Oncology, Peter MacCallum Cancer, Melbourne, Victoria, Australia
Division of Colorectal Surgery, Leicester Royal Infirmary, Leicester, UK
Association of Coloproctology of Great Britain and Ireland (ACPGBI)
Type of Clinical Study or Trial: Survey
Appears in Collections:Cancer Services

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