Characteristics of Early-Onset vs Late-Onset Colorectal Cancer : A Review
(2021) In JAMA Surgery 156(9). p.865-874- Abstract
Importance: 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 a... (More)
Importance: 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 a Westernized 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.
(Less)
- author
- contributor
- Buchwald, Pamela
LU
and Gutlic, Ida
LU
- author collaboration
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- JAMA Surgery
- volume
- 156
- issue
- 9
- pages
- 865 - 874
- publisher
- American Medical Association
- external identifiers
-
- scopus:85114982910
- pmid:34190968
- ISSN
- 2168-6254
- DOI
- 10.1001/jamasurg.2021.2380
- language
- English
- LU publication?
- no
- id
- f1740b0e-9aea-4d38-a348-361b73a10b39
- date added to LUP
- 2021-12-29 11:30:22
- date last changed
- 2024-04-20 19:35:44
@article{f1740b0e-9aea-4d38-a348-361b73a10b39,
abstract = {{<p>Importance: 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.</p><p>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 a Westernized 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.</p><p>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.</p>}},
author = {{Zaborowski, Alexandra M and Abdile, Ahmed and Adamina, Michel and Aigner, Felix and d'Allens, Laura and Allmer, Caterina and Álvarez, Andrea and Anula, Rocio and Andric, Mihailo and Atallah, Sam and Bach, Simon and Bala, Miklosh and Barussaud, Marie and Bausys, Augustinas and Bebington, Brendan and Beggs, Andrew and Bellolio, Felipe and Bennett, Melissa-Rose and Berdinskikh, Anton and Bevan, Vicki and Biondo, Sebastiano and Bislenghi, Gabriele and Bludau, Marc and Boutall, Adam and Brouwer, Nelleke and Brown, Carl and Bruns, Christiane and Buchanan, Daniel D and Burger, Jacobus W A and Burlov, Nikita and Campanelli, Michela and Capdepont, Maylis and Carvello, Michele and Chew, Hwee-Hoon and Christoforidis, Dimitri and Clark, David and Climent, Marta and Cologne, Kyle G and Contreras, Tomas and Croner, Roland and Daniels, Ian R and Dapri, Giovanni and Davies, Justin and Delrio, Paolo and Denost, Quentin and Deutsch, Michael and Dias, Andre and Park, Jason}},
issn = {{2168-6254}},
language = {{eng}},
number = {{9}},
pages = {{865--874}},
publisher = {{American Medical Association}},
series = {{JAMA Surgery}},
title = {{Characteristics of Early-Onset vs Late-Onset Colorectal Cancer : A Review}},
url = {{http://dx.doi.org/10.1001/jamasurg.2021.2380}},
doi = {{10.1001/jamasurg.2021.2380}},
volume = {{156}},
year = {{2021}},
}