Background: The Asia Pacific consensus for colorectal cancer (CRC) recommends that screening program should begin by the age of 50. However, there have been reports about increasing incidence ofCRC at a younger age (i.e. early-onset CRC). Little has been known about the features of early-onset CRC in Vietnamese population. Aim: To describe the clinical, endoscopic and pathological characteristics of early-onset CRC in Vietnamese population. Method: A prospective, cross-sectional study was conducted at the University Medical Center from March 2009 to March 2011. All patients with definite pathological diagnosis of CRC were recruited. Early-onset CRC group were analyzed in comparison with the late-onset (i.e. or = 50-year-old) CRC group. Results: The rate of early-onset CRC was 28 percent (112/400) with the male-to-female ratio of 1.3, 22.3 percent (25/112) of patients only experienced abdominal pain and/or change in bowel habit without alarming symptoms. 42.9 percent (48/112) ofpatients considered their symptoms as intermittent pattern. The rate of familial history of CRC in early-onset group was significantly higher that of the late-onset group (21.4 percent versus 7.6 percent, p 0.001). The distribution of CRC lesions in rectum, distal and proximal colon were 51.8 percent (58/112), 26.8 percent 30/112 and 21.4 percent 24/11 respectively; Which was not different from thatin the late-onset group. The rates of poorly differentiated tumor were also not significantly different between the two groups: 12.4 percent (14/112) in early-onset group versus 8.3 percent (24/288) in late-onset group (X2, p
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