Presentation of Rectal Cancer Among Young Adults in a Tertiary Care Center.

BACKGROUND: Rectal cancer, once predominantly associated with older adults, has shown a rising incidence among young adults in recent decades. This trend raises significant concerns about diagnostic delays, advanced disease presentation, and the unique challenges faced by this population. This study investigates the patterns and characteristics of rectal cancer among young adults presenting to a tertiary care center over a six-month period. METHODOLOGY: A cross-sectional study was conducted, reviewing patients aged 18-45 years diagnosed with rectal cancer between January 2025 and June 2025. Data were collected on demographics, clinical presentation, tumor staging, histopathology, and treatment modalities. Statistical analyses were performed to identify trends and correlations, particularly focusing on symptomatology and delays in diagnosis. RESULTS: A total of 73 young adults (n = 73) were included, with a mean age of 32.5 ± 7.2 years. There was a male predominance, with 44 patients (60.3%) being male. The most common presenting symptom was per rectal bleeding, reported in 54 patients (74.0%), followed by altered bowel habits with lower abdominal pain in 10 patients (13.7%). Delayed diagnosis was common, as 53 patients (72.6%) presented at advanced stages (stage IIIB or IV). The lower rectum was the most frequent tumor site, observed in 35 patients (47.9%). Adenocarcinoma was the predominant histological subtype in 41 patients (56.2%), with a high prevalence of poorly differentiated tumors in 47 patients (64.4%) and signet ring cell carcinoma in 22 patients (30.1%). Common associated risk factors included a low-fiber diet in 42 patients (57.5%) and smoking in 18 patients (24.7%). CONCLUSION: The rising incidence of rectal cancer in young adults and its tendency to present at advanced stages highlight the critical need for increased awareness among both clinicians and the public. Early recognition of symptoms and timely diagnostic evaluations are essential to improving outcomes. Targeted strategies, including awareness campaigns and risk stratification in younger populations, are recommended to address this emerging healthcare challenge.