Characteristics of Early-Onset vs Late-Onset Colorectal Cancer

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dc.contributor.authorZaborowski, A.M.
dc.contributor.authorAbdile, A.
dc.contributor.authorAdamina, M.
dc.contributor.authorAigner, F.
dc.contributor.authord’Allens, L.
dc.contributor.authorAllmer, C.
dc.contributor.authorÁlvarez, A.
dc.contributor.authorAnula, R.
dc.contributor.authorAndric, M.
dc.contributor.authorAtallah, S.
dc.contributor.authorBach, S.
dc.contributor.authorBala, M.
dc.contributor.authorBarussaud, M.
dc.contributor.authorBausys, A.
dc.contributor.authorBebington, B.
dc.contributor.authorBeggs, A.
dc.contributor.authorBellolio, F.
dc.contributor.authorBennett, M.-R.
dc.contributor.authorBerdinskikh, A.
dc.contributor.authorBevan, V.
dc.contributor.authoret al.
dc.date.issued2021
dc.descriptionPublished online June 30, 2021. Corrected on August 11, 2021.
dc.description.abstractIMPORTANCE The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. OBSERVATIONS Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include aWesternized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. CONCLUSIONS AND RELEVANCE The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.
dc.description.statementofresponsibilityREACCT Collaborative: Alexandra M. Zaborowski ... Hidde Maarten Kroon ... Tarik Sammour ... et al.
dc.identifier.citationJAMA Surgery, 2021; 156(9):865-874
dc.identifier.doi10.1001/jamasurg.2021.2380
dc.identifier.issn2168-6254
dc.identifier.issn2168-6254
dc.identifier.orcidKroon, H.M. [0000-0002-8923-7527]
dc.identifier.orcidSammour, T. [0000-0002-4918-8871]
dc.identifier.urihttps://hdl.handle.net/2440/140276
dc.language.isoen
dc.publisherAmerican Medical Association
dc.rights© 2021 American Medical Association. All rights reserved.
dc.source.urihttps://doi.org/10.1001/jamasurg.2021.2380
dc.subjectREACCT Collaborative
dc.subject.meshHumans
dc.subject.meshColorectal Neoplasms
dc.subject.meshIncidence
dc.subject.meshRisk Factors
dc.subject.meshAge of Onset
dc.subject.meshAdult
dc.subject.meshMiddle Aged
dc.titleCharacteristics of Early-Onset vs Late-Onset Colorectal Cancer
dc.typeJournal article
pubs.publication-statusPublished

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