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. 2025 May 2;122(9):235-239.
doi: 10.3238/arztebl.m2025.0018.

Clinical Features in Patients With Early-Onset Colorectal Cancer: An Evaluation of Data From the StuDoQ Database

Ulrich Wirth  1 , Josefine Schardey  1 , Florian Scholz  1 , Tobias Niedermaier  2 , Christoph-Thomas Germer  3 , Anton J Kroesen  4 , Dimitrios Pantelis  5 , Christoph Reissfelder  6 , Markus Rentsch  7 , Jörg-Peter Ritz  8 , Nico Schäfer  9 , Joachim Andrassy  1 , Jens Werner  1 , Florian Kühn  1 ; StuDoQ registries members
Collaborators, Affiliations

Clinical Features in Patients With Early-Onset Colorectal Cancer: An Evaluation of Data From the StuDoQ Database

Ulrich Wirth et al. Dtsch Arztebl Int. .

Abstract

Background: The incidence of colorectal cancer (CRC) in patients who are less than 50 years old (early-onset colorectal cancer, EO-CRC) has risen markedly around the world in recent decades. Because of a lack of early detection programs for young patients, EO-CRC is often not detected until it has reached an advanced stage. In this study, we compared surgical patients with EO-CRC to those with so-called average-onset CRC (> 50 years; AO-CRC) using data from a large patient collective.

Methods: 63 565 cases of CRC from the years 2013-2022 were identified in the StuDoQ database of the German Society for General and Visceral Surgery (Deutsche Gesellschaft für Allgemeinund Viszeralchirurgie, DGAV) and were analyzed on the basis of tumor-related and perioperative data for each of two groups, EO-CRC (3549 patients) and AO-CRC (60 016 patients).

Results: The mean age in the two groups was 42.50 ± 6.3 and 71.59 ± 10.3 years. In the EO-CRC group, 26.2% of the patients were under 40, and 50.4% were under 45. Men predominated in both groups. The distribution of tumor sites differed, with more rectal carcinoma and left-sided CRC in the EO-CRC group. More patients had nodal or distant metastases in the EO-CRC group. Compared to patients in the AO-CRC group, those in the EO-CRC group much more commonly had inflammatory bowel disease (OR 5.83, 95% confidence interval [4.73; 7.16]), a genetic predisposition (OR 4.36 [3.54;5.35]), or a positive family history (OR 4.54 [4.17; 4.95]).

Conclusion: This analysis reveals that patients with EO-CRC differ markedly from those with AO-CRC in tumor-related data, multimodal treatment approaches, and perioperative outcomes. Risk-based, individualized early detection programs should be established to prevent the progression of undetected EO-CRC.

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Figures

eFigure 1
eFigure 1
a) CONSORT diagram showing the treatment of cases included; b) Overview of the distribution of German, Austrian, and Swiss hospitals participating in the colon cancer and rectal cancer StuDoQ registries of the German Society for General and Visceral Surgery (Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie, DGAV) at the time of the study
eFigure 2
eFigure 2
a) Histogram of the EO-CRC and AO-CRC groups b) Cumulative age distribution of the EO-CRC and AO-CRC groups c) Tumor localization for the EO-CRC and AO-CRC age groups AO, average onset colorectal cancer; EO, early onset colorectal cancer
See this image and copyright information in PMC

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