Early-Onset Gastrointestinal Cancers: A Review

Area of Science:

• Oncology
• Gastroenterology
• Genetics

Background:

• Early-onset gastrointestinal (GI) cancer, diagnosed before age 50, is increasing worldwide and is the fastest-growing early-onset cancer in the US.
• Colorectal cancer (CRC) is the most common early-onset GI cancer globally and in the US, followed by gastric, esophageal, and pancreatic cancers.
• Modifiable risk factors include obesity, poor diet, sedentary lifestyle, smoking, and alcohol; nonmodifiable factors include family history and hereditary syndromes.

Purpose of the Study:

• To summarize the current landscape of early-onset GI cancers, including incidence, risk factors, diagnosis, treatment, and prognosis.
• To highlight the importance of genetic testing for guiding treatment and assessing familial risk.
• To underscore the need for improved prevention and early detection strategies.

Main Methods:

• Review of global and US incidence data for early-onset GI cancers in 2022.
• Analysis of associated modifiable and nonmodifiable risk factors.
• Overview of current diagnostic and treatment approaches, including genetic testing.
• Comparison of outcomes and survival rates with later-onset GI cancers.

Main Results:

• Early-onset GI cancers are increasingly prevalent, with CRC being the most common type.
• A significant percentage of early-onset GI cancers are linked to genetic predispositions.
• Treatment protocols are similar to those for later-onset cancers, but survival rates are comparable or worse.
• Specialized centers offer support for fertility, psychosocial distress, and financial difficulties.

Conclusions:

• Early-onset GI cancers represent a growing global health concern with significant impact on younger populations.
• Genetic testing is crucial for personalized treatment and risk assessment in early-onset GI cancers.
• Improved prevention and early detection methods are urgently needed to improve patient outcomes.