Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review

REACCT Collaborative

doi:10.1001/jamasurg.2021.2380

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review

REACCT Collaborative

Department of Clinical Medicine - The Department of Surgical Gastroenterology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Review › Research › peer-review

1 Citation (Scopus)

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 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.

Original language	English
Journal	JAMA Surgery
Volume	156
Issue	9
Pages (from-to)	865-874
Number of pages	10
ISSN	2168-6254
DOIs	https://doi.org/10.1001/jamasurg.2021.2380
Publication status	Published - Sept 2021

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10.1001/jamasurg.2021.2380

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@article{ca84414ef85c4c6da67503e1aeeb6d0e,

title = "Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review",

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 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. ",

author = "Zaborowski, {Alexandra M.} and Ahmed Abdile and Michel Adamina and Felix Aigner and Laura D'Allens and Caterina Allmer and Andrea {\'A}lvarez and Rocio Anula and Mihailo Andric and Sam Atallah and Simon Bach and Miklosh Bala and Marie Barussaud and Augustinas Bausys and Brendan Bebington and Andrew Beggs and Felipe Bellolio and Bennett, {Melissa Rose} and Anton Berdinskikh and Vicki Bevan and Sebastiano Biondo and Gabriele Bislenghi and Marc Bludau and Adam Boutall and Nelleke Brouwer and Carl Brown and Christiane Bruns and Buchanan, {Daniel D.} and Pamela Buchwald and Burger, {Jacobus W.A.} and Nikita Burlov and Michela Campanelli and Maylis Capdepont and Michele Carvello and Chew, {Hwee Hoon} and Dimitri Christoforidis and David Clark and Marta Climent and Cologne, {Kyle G.} and Tomas Contreras and Roland Croner and Daniels, {Ian R.} and Giovanni Dapri and Justin Davies and Paolo Delrio and Quentin Denost and Michael Deutsch and Andre Dias and Andr{\'e} D'Hoore and Iversen, {Lene Hjerrild} and {REACCT Collaborative}",

year = "2021",

month = sep,

doi = "10.1001/jamasurg.2021.2380",

language = "English",

volume = "156",

pages = "865--874",

journal = "JAMA Surgery",

issn = "2168-6254",

publisher = "The JAMA Network",

number = "9",

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TY - JOUR

T1 - Characteristics of Early-Onset vs Late-Onset Colorectal Cancer

T2 - A Review

AU - Zaborowski, Alexandra M.

AU - Abdile, Ahmed

AU - Adamina, Michel

AU - Aigner, Felix

AU - D'Allens, Laura

AU - Allmer, Caterina

AU - Álvarez, Andrea

AU - Anula, Rocio

AU - Andric, Mihailo

AU - Atallah, Sam

AU - Bach, Simon

AU - Bala, Miklosh

AU - Barussaud, Marie

AU - Bausys, Augustinas

AU - Bebington, Brendan

AU - Beggs, Andrew

AU - Bellolio, Felipe

AU - Bennett, Melissa Rose

AU - Berdinskikh, Anton

AU - Bevan, Vicki

AU - Biondo, Sebastiano

AU - Bislenghi, Gabriele

AU - Bludau, Marc

AU - Boutall, Adam

AU - Brouwer, Nelleke

AU - Brown, Carl

AU - Bruns, Christiane

AU - Buchanan, Daniel D.

AU - Buchwald, Pamela

AU - Burger, Jacobus W.A.

AU - Burlov, Nikita

AU - Campanelli, Michela

AU - Capdepont, Maylis

AU - Carvello, Michele

AU - Chew, Hwee Hoon

AU - Christoforidis, Dimitri

AU - Clark, David

AU - Climent, Marta

AU - Cologne, Kyle G.

AU - Contreras, Tomas

AU - Croner, Roland

AU - Daniels, Ian R.

AU - Dapri, Giovanni

AU - Davies, Justin

AU - Delrio, Paolo

AU - Denost, Quentin

AU - Deutsch, Michael

AU - Dias, Andre

AU - D'Hoore, André

AU - Iversen, Lene Hjerrild

AU - REACCT Collaborative

PY - 2021/9

Y1 - 2021/9

N2 - 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.

AB - 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.

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U2 - 10.1001/jamasurg.2021.2380

DO - 10.1001/jamasurg.2021.2380

M3 - Review

C2 - 34190968

AN - SCOPUS:85114982910

SN - 2168-6254

VL - 156

SP - 865

EP - 874

JO - JAMA Surgery

JF - JAMA Surgery

IS - 9

ER -

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review

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