Young-onset colorectal cancer

doi:10.1038/s41572-023-00432-7

Young-onset colorectal cancer

2023-04-27

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Manon C.W. Spaander *

DOI：10.1038/s41572-023-00432-7

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Abstract

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In the past decades the incidence of colorectal cancer (CRC) in people under the age of 50 years has increased, which is referred to as early-onset CRC or young-onset CRC (YO-CRC). YO-CRC is expected to account for 11% of colon cancers and 23% of rectal cancers by 2030. This trend is observed in different parts of the world and in both men and women. In 20% of patients with YO-CRC, a hereditary cancer syndrome is found as the underlying cause; however, in the majority of patients no genetic predisposition is present. Beginning in the 1950s, major changes in lifestyle such as antibiotic use, low physical activity and obesity have affected the gut microbiome and may be an important factor in YO-CRC development. Owing to a lack of screening, patients with YO-CRC are often diagnosed with advanced-stage disease. Long-term treatment-related complications should be taken into account in these younger patients, making the more traditional sequential approaches of drug therapy not always the most appropriate option. To better understand the underlying mechanism and define relationships between environmental factors and YO-CRC development, long-term prospective studies are needed with lifestyle data collected from childhood. Young-onset colorectal cancer occurs in individuals younger than 50 years and is increasing in incidence worldwide. This Primer provides an overview of the epidemiology, diagnosis, screening, prevention, pathophysiology and management of this cancer and its impact on patient quality of life.

Keywords:

CLINICAL-PRACTICE GUIDELINES

FAMILIAL ADENOMATOUS POLYPOSIS

QUALITY-OF-LIFE

SUSCEPTIBILITY GENE-MUTATIONS

SOCIETY TASK-FORCE

LONG-TERM USE

LYNCH-SYNDROME

RISK-FACTORS

MISMATCH REPAIR

COLON-CANCER

Young-onset colorectal cancer

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