Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer

Area of Science:

• Oncology
• Gastroenterology
• Public Health

Background:

• Early-onset colorectal cancer (EO-CRC) incidence is rising, posing a significant public health challenge.
• EO-CRC is often associated with a poorer prognosis compared to late-onset colorectal cancer (LO-CRC).
• Understanding the distinct characteristics of EO-CRC is crucial for improving patient outcomes.

Purpose of the Study:

• To identify epidemiological, clinical, and paraclinical factors contributing to the aggressive nature of EO-CRC.
• To compare the characteristics of EO-CRC with those of LO-CRC.

Main Methods:

• Retrospective study of 204 colorectal cancer (CRC) patients over two years.
• Patients were categorized into EO-CRC and LO-CRC subgroups.
• Statistical analysis was performed using IBM SPSS Statistics, Version 29.0.

Main Results:

• EO-CRC accounted for 11.3% of cases and showed a trend towards more distal tumors and stenotic appearance.
• EO-CRC patients had a higher incidence of mucinous histology (34.8% vs. 14.4%) and poorly differentiated tumors (39.1% vs. 14.5%).
• Increased HER2 positivity (p=0.002) and reduced CDX2 positivity (p=0.012) were observed in EO-CRC, alongside higher prevalence of smoking and hypertension.

Conclusions:

• EO-CRC patients exhibit unique histopathological and molecular profiles, including mucinous subtype, poor differentiation, and altered HER2/CDX2 expression, contributing to aggressive disease.
• Lifestyle factors like smoking and hypertension are more common in EO-CRC patients.
• Findings support the need for tailored screening and personalized treatment strategies for younger CRC patients.