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Young-onset colorectal cancer.

Manon C W Spaander1, Ann G Zauber2, Sapna Syngal3,4,5

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The incidence of young-onset colorectal cancer (YO-CRC) is rising globally. Lifestyle factors impacting the gut microbiome may drive YO-CRC development, necessitating further research.

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Area of Science:

  • Oncology
  • Gastroenterology
  • Public Health

Background:

  • Colorectal cancer (CRC) incidence is increasing in individuals under 50, termed young-onset CRC (YO-CRC).
  • YO-CRC is projected to represent a significant portion of all CRC cases by 2030.
  • While 20% of YO-CRC cases have a hereditary basis, most lack a clear genetic predisposition.

Purpose of the Study:

  • To investigate the rising trend of young-onset colorectal cancer (YO-CRC).
  • To explore the potential role of lifestyle factors and the gut microbiome in YO-CRC development.
  • To highlight the need for long-term prospective studies on environmental influences in YO-CRC.

Main Methods:

  • Review of global trends in YO-CRC incidence.
  • Analysis of potential contributing factors, including lifestyle changes since the 1950s (e.g., antibiotic use, physical activity, obesity).
  • Examination of the gut microbiome's role in YO-CRC pathogenesis.

Main Results:

  • YO-CRC incidence is increasing worldwide in both men and women.
  • Lifestyle changes affecting the gut microbiome are implicated as potential drivers of YO-CRC.
  • Patients with YO-CRC are often diagnosed at advanced stages due to lack of screening.

Conclusions:

  • Understanding the interplay between environmental factors and the gut microbiome is crucial for YO-CRC prevention and treatment.
  • Traditional treatment approaches may require modification for younger patients due to long-term complication risks.
  • Long-term prospective studies collecting childhood lifestyle data are essential to elucidate YO-CRC mechanisms.