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Review
. 2023 Jun 15;15(12):3202.
doi: 10.3390/cancers15123202.

Early-Onset Colorectal Cancer: Current Insights

Fauzia Ullah  1 , Ashwathy Balachandran Pillai  2 , Najiullah Omar  1 , Danai Dima  1   3 , Seema Harichand  4
Affiliations
Review

Early-Onset Colorectal Cancer: Current Insights

Fauzia Ullah et al. Cancers (Basel). .

Abstract

Over the past decade, the incidence of colorectal cancer has increased in individuals under the age of 50 years. Meanwhile, the incidence has gradually decreased in the older population. As described herein, we reviewed the available literature to summarize the current landscape of early-onset colorectal cancer, including risk factors, clinicopathological presentation, genetic makeup of patients, and management. Currently, early-onset colorectal cancer is treated similarly as late-onset colorectal cancer, yet the available literature shows that early-onset colorectal cancer is more aggressive and different, and this remains a significant unmet need. A detailed understanding of early-onset colorectal cancer is needed to identify risk factors for the increased incidence and tailor treatments accordingly.

Keywords: Lynch syndrome; early-onset colorectal cancer; genetic makeup; modifiable risk factors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Risk factors for the development of early-onset colorectal cancer. Abbreviations: EOCRC, early-onset colorectal cancer; IBD, inflammatory bowel disease.
Figure 2
Figure 2
Molecular pathogenesis and classification of CRC. (a) key mutations that are required for progression along the adenoma–carcinoma sequence in the chromosomal instability (CIN) pathway. Progression in this pathway with mutations in K-ras, etc., and TP53 leads to carcinoma. (b) The DNA mismatch repair (MMR) gene MLH1 can be inactivated either by a mutation or by promoter hypermethylation, which typically occurs in the context of the CpG island methylator phenotype (CIMP). B-Raf mutations and MLH1 hypermethylation are associated with serrated polyps pathway. (c) Key mutations in the microsatellite instability high (MSI-H) pathway. Abbreviations: APC, adenomatous polyposis coli; COX2, cyclooxygenase 2; LOH, loss of heterozygosity; MSS, microsatellite stable.
Figure 3
Figure 3
Colorectal cancer screening options.
See this image and copyright information in PMC

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