The alarming rise of early-onset colorectal cancer

Over the past 20 years of the Australian National Bowel Cancer Screening Program, there has been a reduction in Australia's overall rates of colorectal cancer. However, during this same period, there has been a steady rise in the incidence of early-onset colorectal cancer (EOCRC), presenting a new public health issue.

The aim of this study was to evaluate the literature regarding the rising incidence of EOCRC, highlight the importance of the recent reduction in screening age and document what might be done in a primary healthcare setting.

The increasing incidence of EOCRC has been largely attributed to risk factors including a Western diet, obesity, tobacco use and alcohol intake, which contribute to microbiome dysgenesis and chronic inflammation from an early age. In response, the initial screening age for colorectal cancer was lowered to 45 years from July 2024 via an opt-in system; however, there is evidence to support a further reduction in screening age to 40 years.