Non-polyposis Colorectal Cancers in Northeastern Iran: A Familial Approach

Background: There are no data on familial aggregation of colorectal cancer (CRC) in northeastern Iran. The aim of this study was to determine the prevalence of early-onset CRC and patients suspected for hereditary non-polyposis colorectal cancer (HNPCC) based on the clinical criteria in this area. Materials and Methods: Documents were collected from two hospitals in Mashhad regarding 326 inpatients during 2013-2015. Demographics, clinical, and tumor-related features were recorded. Interviews were done to identify cancer in the family up to seconddegree relatives. Results: 326 patients with CRC (48.5% male) were evaluated. The mean age at diagnosis was 55.44±14.85 years, with 91 patients (27.9%) below 45 years old. Eleven (3.4%) patients fulfilled the Amsterdam II criteria and 136 (41.7%) patients met at least one criterion of the revised Bethesda guideline. There was no difference between early- and late-onset CRC regarding the frequency of CRC in 1st degree relatives or tumor site (p=0.73, p =0.64). However, CRC in second-degree relatives and cases suspected for HNPCC were more common in early-onset of the disease (p =0.022, p =0.024). The patients who fulfilled the Amsterdam II criteria had lower mean age and higher frequency of proximal cancer (p =0.03, p =0.048). Conclusion: VAs CRC is common in the young population and CRC clustering and patients suspected for HNPCC are also frequently encountered, measures should be taken to CRC screening policy and genetic studies in this area.