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Approach Toward Early Detection and Prevention of Early-Onset Colorectal Cancer
Cassandra D L Fritz1,2, Manju George3,4,5, John M Carethers6,7,8
1Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
Annual Review of Medicine
|November 7, 2025
Summary
Early-onset colorectal cancer (CRC) is rising in those under 50. This review highlights patient and provider barriers causing diagnostic delays and discusses prevention strategies for earlier detection.
Area of Science:
- Oncology
- Public Health
- Gastroenterology
Background:
- Early-onset colorectal cancer (CRC) diagnoses are increasing in individuals under 50.
- Younger patients often experience significant delays in diagnosis despite presenting with symptoms.
Purpose of the Study:
- To review clinical barriers hindering early detection of early-onset CRC.
- To outline diagnostic pathway challenges and identify opportunities for improved prevention.
Main Methods:
- Literature review of diagnostic pathways for early-onset CRC.
- Analysis of patient- and provider-level barriers to timely diagnosis.
- Examination of secondary (screening) and primary (lifestyle) prevention strategies.
Main Results:
- Diagnostic delays are attributed to both patient- and provider-related factors.
- Symptom recognition and early detection are frequently complicated.
- Opportunities exist for enhancing screening and lifestyle modification interventions.
Conclusions:
- A multifaceted approach is essential for advancing early-onset CRC detection and prevention.
- Enhanced public awareness, innovation, and public health initiatives are critical.
- Addressing diagnostic delays and improving prevention are key to combating rising CRC rates in younger populations.
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