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Canadian Journal of Gastroenterology
Volume 18, Issue 5, Pages 319-320
Brief Communication

Advanced Colon Cancer Before the Age of 20 Years: A Case for Extension of the Current Colonscopy Surveillance Guidelines in Hereditary Nonpolyposis Colorectal Cancer Syndrome

Victor K Wong,1 Eric M Yoshida,1 Anthony G Ryan,2 Stephen GF Ho,2 and Baljinder Salh1

1Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
2Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada

Received 2 January 2004; Accepted 10 February 2004

Copyright © 2004 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Hereditary nonpolyposis colorectal cancer (HNPCC) currently accounts for between 2% to 6% of all colorectal adenocarcinomas. Controversies exist regarding the current guidelines for colonoscopic screening for colon cancer.

CASE REPORT: A case of colon cancer in a young Japanese man with a family history of colon cancer that did not meet the criteria for HNPCC is reported. A malignant pelvic mass discovered shortly before his 20th birthday prompted a colonoscopy. The findings at colonscopy determined that the patient and his family fulfilled the criteria of HNPCC.

CONCLUSION: Before finding a pelvic mass metastatic from adenocarcinoma of the ascending colon, this patient was clearly outside of the current guidelines for HNPCC screening. It is suggested that in similar patients, even if they do not fulfill all the criteria for HNPCC, it would be appropriate to consider screening well before the recommended lower age.