Objective      To compare the clinical pathological characteristics in young and old patients with colorectal cancer (CRC) and investigate their relationship with prognosis.      Methods     A retrospective review was made in 68 CRC patients less than 35 years old and 322 CRC patients older than 65 treated in our hospital from July 1993 to July 2003. Their clinical manifestation

pathological feature

Dukes staging

misdiagnosis

rate and results of following-up were compared.      Results     The main manifestation in young group was abdominal pain (69.1%)

but in old group was hemafecia or mucous bloody stools (53.7%). The ratio of poorly differentiated neoplasm was obviously higher in young group (48.5%) than in old group (20.5%) (

P

<

0.01). The ratio of Dukes C and D stage in young group (80.9%) was remarkably higher than in old group (50.3%) (

P

<

0.01). The misdiagnosis rate was markedly higher in young group (64.7%) than in old group (14.0%)(

P

<

0.01). The 3-year survival rate was higher in old group (67.3%)  than that in young group (33.9%) (

P

<

0.01)

and the 3-year survival rate of patients with poorly differentiated tumor (15.6%) or of Dukes C and D stage (25.0%) was obviously lower in young group than that in old group (43.4%

51.2%).      Conclusion     Compared with old group

young group is mainly of intermediate or advanced stage and has a higher misdiagnosis rate and poorer prognosis. Therefore

the early diagnosis of CRC in patients less than 35 years old should be enforced.