Breast, colon cancer rare but aggressive in kids

November 13, 2014

Breast and colorectal cancers, although rare in children, are also more aggressive than in adults, according to 2 studies based on patient records from the National Cancer Data Base that were presented at the recent Clinical Congress of the American College of Surgeons.

Breast and colorectalcancers, although rare in children, are also more aggressive than in adults, according to 2 studies based on patient records from the National Cancer Data Base (NCDB) that were presented at the recent Clinical Congress of the American College of Surgeons.

In the first study, researchers from Seattle Children’s Hospital reviewed NCDB records for breast cancer patients from 1998 to 2011. Only 574 of 2,636,722 patients were aged younger than 21 years. In striking contrast with adult patients, younger patients were much more likely to be African American (more than 25% compared with 10% of adults) and have more aggressive cancers, which were detected at a later stage. Younger patients also were more apt to be male and uninsured.

Puzzler: Boy's lymphadenopathy leads to acute heart failure

Pediatric patients waited a week longer than adults between diagnosis and surgery, perhaps because the rarity of cancer in the young may lead to an additional biopsy or secondary pathologic confirmation. They also waited longer than adults between definitive surgery and chemotherapy or radiation, 100 days longer in the case of radiation. The cause of the delay is unknown.

In the second study, researchers from Maine Medical Center in Portland examined NCDB records on colorectal cancer patients in the largest study so far and the first to compare pediatric and adult colorectal cancer patients directly. They found 920 patients aged younger than 21 years; 157,779 patients between 22 and 50 years; and 1,305,085 patients aged older than 50 years.

Patients aged 21 years and younger were more likely than adults to have stage III or stage IV cancer and had more aggressive tumors at similar stages. They more often underwent extensive surgery, such as removal of the entire colon and rectum. Nevertheless, their 5-year survival rates were lower than those of young adults.

It’s too early to draw direct conclusions about treatment, the researchers of both studies say, but their findings can make pediatricians more aware of the existence and different characteristics of breast and colorectal cancer in children. More information about pediatric patients may increase understanding of these cancers in patients of all ages, they note.

 

To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics PediaMedia.