Aspects épidémiologiques et cliniques du cancer colorectal a début précoce : Etude comparative à propos de 180 cas
DOI :
https://doi.org/10.62438/tunismed.v103i8.5904Mots-clés :
Cancer colorectal , début précoce , facteurs de risque , épidémiologieRésumé
Introduction : L’incidence du cancer colorectal (CCR) à début précoce, défini par une survenue avant 50 ans, est en nette augmentation. Si les syndromes génétiques en expliquent une minorité des cas, la majorité sont sporadiques, résultant d’une interaction entre facteurs génétiques et environnementaux. L’objectif de notre étude était d’identifier les particularités épidémiologiques et cliniques du CCR à début précoce.
Méthodes : Étude monocentrique, rétrospective et comparative, menée sur sept ans, incluant 180 patients atteints de CCR, répartis en <50 ans (G1) et ≥50 ans (G2). Les données cliniques, tumorales et thérapeutiques ont été comparées.
Résultats : Le G1 représentait 26,1 % des patients. Aucune différence significative n’a été observée concernant le sex-ratio, le tabagisme, la consommation d’alcool, l’obésité ou les antécédents familiaux de cancer. Cliniquement, les troubles du transit et l’altération de l’état général étaient fréquents dans les deux groupes, mais la diarrhée (p = 0,015) et les rectorragies (p = 0,026) prédominaient en G1. La localisation rectale était plus fréquente en G1 (p < 0,001). Histologiquement, le CCR précoce était plus souvent peu différencié, avec une atteinte ganglionnaire et un diagnostic à un stade avancé, bien que sans différence significative. Un traitement curatif était plus fréquemment proposé en G1, sans différence statistiquement significative.
Conclusion : Le CCR à début précoce représentait plus d'un quart des cas de CCR dans notre étude. Dans cette population, la localisation rectale était prédominante, et le diagnostic était souvent posé à un stade avancé de la maladie.
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