• Early-onset colorectal cancer
• Family care
• Prediction model
• Psychosocial adjustment
• Return-to-work self-efficacy
• Returning to work

• First Nations Indigenous Australians
• aboriginal and Torres Strait islander peoples
• bowel cancer
• early onset bowel cancer
• young‐onset bowel cancer

• Humans
• Male
• Female
• Middle Aged
• Queensland/epidemiology
• Adult
• Young Adult
• Adolescent
• Incidence
• Survival Rate
• Age of Onset
• Early Detection of Cancer

• GNT 1176651 National Health and Medical Research Council
• GNT 2015290 National Health and Medical Research Council
• GNT#1153027 Centre of Research Excellence (CRE) in Targeted Approaches To Improve Cancer Services for Aboriginal and Torres Strait Islander Australians
• National Health and Medical Research Council

• Arab
• Colorectal cancer
• early onset
• family history

• Humans
• Colorectal Neoplasms/epidemiology
• Colorectal Neoplasms/diagnosis
• Female
• Male
• Middle Aged
• Age of Onset
• Aged
• Risk Factors
• Comorbidity
• Adult
• Retrospective Studies

• Colorectal cancer
• Early-onset
• Epidemiology
• Late-onset
• Meta-analysis
• Rectal cancer

• Humans
• Colorectal Neoplasms/mortality
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/diagnosis
• Prognosis
• Age of Onset
• Neoplasm Recurrence, Local

• Colorectal cancer
• Early-onset of colorectal cancer
• Epithelial cell
• Inflammation
• SERPINA3
• Stroma

• FOXM1
• colorectal cancer
• metastasis
• microRNA

• Cancer survivors
• colorectal neoplasms
• risk factors
• young adult
• young-onset

• K01 CA234319 NCI NIH HHS

• early-onset colorectal cancer
• epithelial–mesenchymal transition
• mucinous tumor

• F-69 Serbian Academy of Sciences and Arts
• 451-03-47/2023-01/200110 Ministry of Education, Science and Technological Development of the Republic of Serbia

• colorectal cancer
• colorectal cancer symptoms
• early-onset
• histopathology
• polyps
• screening

• Carcinoma
• Enterobacteriales
• Genotoxic virulence factors

• Humans
• Escherichia coli
• Prevalence
• Peptides
• Colorectal Neoplasms/epidemiology
• Polyketides

• cancer risk reduction
• chronic disease prevention
• social capital
• social determinants of health
• social network methods

• Humans
• Delivery of Health Care
• Health Literacy
• Learning
• Chronic Disease
• Neoplasms/epidemiology
• Neoplasms/prevention & control

• CPIMP211238-01 US Department of Health and Human Services

• colorectal cancer
• early-onset
• epidemiology
• incidence
• pathophysiology
• prevention
• young adults

• Israel
• cancer
• colorectal
• colorectal cancer
• decision support
• decision tree
• drug
• drugs
• early onset colorectal cancer
• gastroenterology
• gastrointestinal
• gradient boosting
• health provider
• increased risk
• internal medicine
• machine learning
• oncology
• pharmaceutical
• pharmaceutical agents
• pharmaceuticals
• risk
• risk factors
• risks

• Young Adult
• Humans
• Adolescent
• Case-Control Studies
• Bayes Theorem
• Anti-Bacterial Agents
• Inflammatory Bowel Diseases
• Colorectal Neoplasms/drug therapy
• Colorectal Neoplasms/epidemiology
• Colorectal Neoplasms/genetics

• P30 CA008748 NCI NIH HHS

• risk factors
• cancer
• cancer epidemiology
• cancer prevention

• Aged
• Female
• Humans
• Male
• Africa, Northern/epidemiology
• Colorectal Neoplasms/epidemiology
• Colorectal Neoplasms/etiology
• Diet/adverse effects
• Global Burden of Disease
• Risk Factors
• Middle East/epidemiology
• Disability-Adjusted Life Years

• Competing risk model
• Early-onset colorectal cancer
• Late-onset colorectal cancer
• Nomogram
• Prognosis
• SEER database
• cancer-specific mortality

• No.2019KJ048 The Tianjin Municipal Education Commission Scientific Research Program (Natural Science) of China

• colorectal cancer
• early onset
• screening

• Humans
• Middle Aged
• Adult
• Colorectal Neoplasms/epidemiology
• Colorectal Neoplasms/genetics
• Colorectal Neoplasms/diagnosis
• Retrospective Studies
• Proto-Oncogene Proteins B-raf/genetics
• Proto-Oncogene Proteins p21(ras)/genetics
• Tertiary Healthcare
• Neoplasm Recurrence, Local
• Adenocarcinoma/epidemiology
• Adenocarcinoma/genetics
• Adenocarcinoma/diagnosis

• CSS
• Early-onset CRC
• Metastatic
• Nomogram
• OS
• Seer

• 20KJB320027 General Project of Natural Science Foundation of Higher Education Institutions of Jiangsu Province

• Early-onset colorectal cancer
• Later-onset colorectal cancer
• Molecular characteristics
• Mutations
• Transcriptomics
• oncogenes

• R03 CA279861 NCI NIH HHS

• 50 Years
• Clinical
• Colorectal Cancer
• Recommendation
• Young

• Humans
• Endoscopy
• Genetic Testing
• Colorectal Neoplasms/diagnosis

• I01 BX004455 BLRD VA
• I01 CX001146 CSRD VA
• P30 CA047904 NCI NIH HHS
• R01 CA220329 NCI NIH HHS

• Diagnostic Biomarker
• Early-Onset Colorectal Cancer
• Liquid Biopsy
• miRNA Panel

• Humans
• Biomarkers, Tumor/genetics
• ROC Curve
• Circulating MicroRNA
• MicroRNAs/genetics
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/genetics
• Liquid Biopsy
• Gene Expression Profiling

• R01 CA202797 NCI NIH HHS
• R01 CA184792 NCI NIH HHS
• R01 CA181572 NCI NIH HHS
• R01 CA072851 NCI NIH HHS
• R01 CA227602 NCI NIH HHS

• MYC
• PVT1
• RNA-sequencing
• early-onset colorectal cancer
• transcriptome

• Carcinogenesis/genetics
• Colorectal Neoplasms/genetics
• Colorectal Neoplasms/pathology
• Gene Expression Profiling
• Gene Expression Regulation, Neoplastic
• Genes, myc
• Humans
• RNA, Long Noncoding/genetics
• RNA, Long Noncoding/metabolism

• R03 CA279861 NCI NIH HHS

• Bayesian projection
• China
• age-period-cohort analysis
• colorectal cancer
• processed meat

• Aged
• Bayes Theorem
• China/epidemiology
• Colorectal Neoplasms/etiology
• Female
• Forecasting
• Humans
• Incidence
• Male
• Meat
• Risk Factors

Given that the onset of diseases including colorectal cancer precursors is affecting younger individuals and that obesity is an important risk factor for early‐onset, we conducted a study to explore the biochemical profile of differences in serum between early‐onset patients and late‐onset colorectal precancerous lesions.

A total of 1447 patients, including 469 early‐onset patients and 978 late‐onset patients, were enrolled from the First Affiliated Hospital of Nanchang University (FAHNU), of which there were 311 sessile serrated adenoma/polyps (SSA/P) and 1136 normal adenomas. The distribution of the included categorical variables was compared via Pearson's chi‐squared test, whereas continuous variables were compared by using the nonparametric Kruskal–Wallis test and anova.

Compared with late‐onset patients, the levels of total bilirubin and HDL‐C were lower (p < 0.05), whereas triglyceride and uric acid levels were higher, in early‐onset patients. Interestingly, in the subgroup analysis, triglyceride and uric acid levels remained at higher levels, whereas HDL‐C remained at lower levels, in early‐onset patients than in late‐onset patients. Other characteristics, such as LDL‐C, drinking, γ‐GT, and the N/L ratio, were similar between the two groups. An additional analysis of the association of tumor size with markers showed that lower levels of HDL‐C and higher levels of uric acid were associated with increased tumor size (p < 0.05).

Early‐onset CRC precursor cases exhibit higher levels of triglycerides and lower levels of HDL‐C than late‐onset cases. Additionally, levels of HDL‐C are negatively associated with tumor size, whereas uric acid was positively correlated with tumor size.

• Adult
• Colorectal Neoplasms/epidemiology
• Early Detection of Cancer
• Global Burden of Disease
• Humans
• Middle Aged
• Quality-Adjusted Life Years
• Risk Factors

• K43 TW010704 FIC NIH HHS

Colorectal cancer in adults 50 years old and younger is increasing in incidence worldwide. Diet may be a modifiable risk factor. The objective of this study was to examine evidence regarding the association between diet and the risk of developing early-onset colorectal cancer (EOCRC) and early-onset colorectal adenomas in young adults.

PUBMED, Web of Science, and Embase were systematically searched for studies examining dietary intake as a risk factor for EOCRC and early-onset colorectal adenomas. Results were synthesized narratively due to the heterogeneity of the studies.

Of the 415 studies identified, ten met the inclusion criteria. Of these ten studies, four provided data on dietary risk factors for early-onset colorectal adenomas and six provided data on dietary risk factors for EOCRC. The four studies that measured colorectal adenoma occurrence reported an increased incidence with high sugar sweetened beverage intake, a higher pro-inflammatory diet, a higher Western diet score and higher sulfur microbial diet score. A protective effect against early-onset colorectal adenomas was observed in those who had a higher Prudent diet score or higher adherence to other health dietary approaches (Dietary Approaches to Stop Hypertension, Alternative Healthy Eating Index-2010, or the alternative Mediterranean diet). Those who consumed large amounts of deep-fried foods, refined foods, followed a high fat diet, consumed large amounts of sugary drinks and desserts, and had low folate and fiber consumption had a significantly higher occurrence of EOCRC. A protective effect against EOCRC was observed for those who consumed more fruits and vegetables, high amounts of micronutrients and those who adhered to a vegetarian diet.

The results of this study reveal various dietary habits may be risk factors or protective against early-onset colorectal cancer and adenomas. Future research should focus on large prospective cohort studies with long-term follow-up to confirm published results and further examine whether differences in diet quality are associated with EOCRC risk.

• colorectal cancer
• diet
• dietary habits
• early-onset
• risk factors

• Colorectal neoplasm
• cancer
• gestational
• postpartum
• pregnancy

• Colorectal cancer
• Epidemiology
• Risk factors
• Young adult

• Aged
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/epidemiology
• Colorectal Neoplasms/etiology
• Humans
• Incidence
• Mass Screening/adverse effects
• Middle Aged
• Risk Factors
• United States
• Young Adult

• R01 CA242558 NCI NIH HHS

• colorectal cancer
• early-onset
• late-onset colorectal cancer
• young adult

The incidence of colorectal cancer (CRC) is increasing in young adults, but knowledge regarding the molecular features of sporadic early-onset colorectal cancer (SEOCRC) is limited. The objective of the present study was to investigate potential key tumorigenesis-associated genes and their regulatory microRNAs (miRNAs) in SEOCRC. Using miRNA and mRNA expression screening of SEOCRC and sporadic late-onset colorectal cancer (SLOCRC) by next generation sequencing (NGS) and bioinformatics, the SEOCRC-associated miRNAome and transcriptome were analyzed. In SEOCRC miRNA and mRNA expression profiles, the tumorigenesis-associated genes and their regulatory miRNAs were analyzed according to the miRTarBase database, and specific miRNA-mRNA pairs were selected as the candidate biomarkers in SEOCRC, which were further verified in another cohort of SEOCRC and SLOCRC patients' colon cancer and paracancerous tissues using reverse transcription-quantitative PCR and immunohistochemistry. Moreover, the clinical relevance of these paired signatures to clinicopathological features was determined in 80 patients with SEOCRC. The expression of dystrophin (DMD) was downregulated and that of miR-31-5p was upregulated in SEOCRC tissue compared with adjacent peritumoral tissue. While DMD and miR-31-5p were not differentially expressed in SLOCRC tissues compared with that in adjacent peritumoral tissues. The miR-31-5p-DMD axis was identified as the key regulatory axis specific to SEOCRC, and DMD expression was closely associated with TNM stage and lymph node metastasis. Importantly, Kaplan-Meier analysis revealed that patients with low DMD expression had significantly poorer overall survival, cancer specific survival and recurrence free survival compared with those with high expression of DMD. In conclusion, the miR-31-5p-DMD axis may serve as a novel biomarker in predicting the development of SEOCRC, and DMD can be used as a promising biomarker for the prognosis of SEOCRC.

Colorectal cancer (CRC) is the third leading cause of cancer-related mortality in men or women in the United States. Average-risk screening that begins at age 50 years has reduced incidence and mortality of CRC in those over 50 years of age, whereas CRC incidence in those under age 50 years (early onset colorectal cancer (eoCRC)) has recently and dramatically increased. In this review, we summarize the recent literature including risk factors for eoCRC, differences in clinicopathologic presentation and outcomes in eoCRC, and emerging evidence regarding the molecular pathways that are altered in eoCRC compared to later onset CRC (loCRC). Epidemiologic studies of eoCRC show predominance in distal colon and rectum, and association with several modifiable risk factors, including diabetes, obesity, diet, sedentary time, alcohol consumption and smoking. Data regarding potential risk factors of prior antibiotic exposure and microbiome alterations or direct carcinogen exposure are still emerging. Aggressive clinicopathologic features of eoCRC at presentation may be due to delay in diagnosis or more aggressive tumor biology. EoCRC outcomes are similar to loCRC when matched for stage, but overall mortality is greater due to higher frequency of advanced disease at a younger presentation, with more life-years lost. There are only few molecular evaluations of eoCRC to date, with findings of potential increase in TP53 and CTNNB1 somatic mutation and decrease in APC, KRAS and BRAF somatic mutation, compared to loCRC. Other findings include LINE-1 hypomethylation, absence of microsatellite instability (MSI-H), presence of chromosomal instability (CIN) or microsatellite and chromosomal stability (MACS). These studies are only now emerging and have not yet identified a specific molecular signature defining eoCRC. Further research evaluating genetic and molecular differences as well as environmental triggers for eoCRCs should provide a clearer understanding to inform targeted screening for pre-symptomatic at-risk younger individuals.

• cancer genetics
• cancer prevention
• cancer risk factors
• cancer screening
• cancer treatment
• colon cancer
• colonoscopy
• diabetes mellitus
• early onset
• genetic testing
• inflammation
• obesity
• rectal cancer
• tumor microenvironment
• young onset

• Colorectal cancer
• Diet
• Early-onset colorectal cancer
• Lifestyle
• Risk factors

• anterior resection
• bowel function
• low anterior resection syndrome
• neoadjuvant radiotherapy
• preoperative radiotherapy
• rectal cancer

• Humans
• Neoadjuvant Therapy/adverse effects
• Postoperative Complications/etiology
• Rectal Neoplasms/pathology
• Rectal Neoplasms/radiotherapy
• Rectal Neoplasms/surgery
• Rectum/pathology
• Syndrome

• the Second Batch of Scientific Research Projects of Dengfeng Plan
• the Research Fund of CSCO-Hansoh Oncology
• the Medical Scientific Research Foundation of Guangdong Province
• the Science and Technology Plan of Guangzhou
• the Research Fund of CSCO-Roche Oncology

Colorectal cancer (CRC) is a heterogeneous disease that commonly affects individuals aged more than 50 years old globally. Regular colorectal screening, which is recommended for individuals aged 50 and above, has decreased the number of cancer death toll over the years. However, CRC incidence has increased among younger population (below 50 years old). Environmental factors, such as smoking, dietary factor, urbanization, sedentary lifestyle, and obesity, may contribute to the rising trend of early-onset colorectal cancer (EOCRC) because of the lack of genetic susceptibility. Research has focused on the role of gut microbiota and its interaction with epithelial barrier genes in sporadic CRC. Population with increased consumption of grain and vegetables showed high abundance of Prevotella, which reduces the risk of CRC. Microbes, such as Fusobacterium nucleatum, Bacteroides fragilis and Escherichia coli deteriorate in the intestinal barrier, which leads to the infiltration of inflammatory mediators and chemokines. Gut dysbiosis may also occur following inflammation as clearly observed in animal model. Both gut dysbiosis pre- or post-inflammatory process may cause major alteration in the morphology and functional properties of the gut tissue and explain the pathological outcome of EOCRC. The precise mechanism of disease progression from an early stage until cancer establishment is not fully understood. We hypothesized that gut dysbiosis, which may be influenced by environmental factors, may induce changes in the genome, metabolome, and immunome that could destruct the intestinal barrier function. Also, the possible underlying inflammation may give impact microbial community leading to disruption of physical and functional role of intestinal barrier. This review explains the potential role of the interaction among host factors, gut microenvironment, and gut microbiota, which may provide an answer to EOCRC.

• colorectal cancer
• early onset
• host microbial interaction
• microbiota
• tight junction proteins

• Bowel cancer
• Intestine
• Therapeutic approaches

• gastroenterology
• gastrointestinal tumours
• public health

• Adolescent
• Adult
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/epidemiology
• Colorectal Neoplasms/prevention & control
• Data Collection
• Humans
• Incidence
• Middle Aged
• Registries
• Risk Factors
• Young Adult

• K01 CA234319 NCI NIH HHS
• School of Medicine
• National Cancer Institute of the National Institutes of Health (NIH)
• V Foundation for Cancer Research
• Huntsman Cancer Institute
• 5 For The Fight
• Research Foundation of the American Society of Colon and Rectal Surgeons

This systematic review sifted through the exogenous dietary and lifestyle risk factors associated with early-onset colorectal cancer, going through the putative involvement of these exogenous risk factors in epigenetic and microbiota modifications. Given the burden of early-onset colorectal cancer and its globally increasing trend with scant literature on its pathogenesis, we believe it would be of benefit to highlight the importance of further systematic and large studies. Indeed, dietary and lifestyle modification could complement colorectal screening for early-onset colorectal cancer prevention.

The incidence of early-onset colorectal cancer, defined as colorectal cancer occurring in young adults under the age of 50, is increasing globally. Knowledge of the etiological factors in young adults is far from complete. Questionable eoCRCs’ exogenous factors are represented by processed meat, sugary drinks, alcohol, Western dietary pattern, overweight and obesity, physical inactivity, and smoking, though with heterogeneous results. Therefore, we performed a systematic review to summarize the current evidence on the role of diet and lifestyle as eoCRC risk factors. We systematically searched PubMed, Scopus, and EMBASE up to July 2021, for original studies evaluating diet, alcohol, physical activity, BMI, and smoking in eoCRC and included twenty-six studies. Indeed, the exogenous factors could represent modifiable key factors, whose recognition could establish areas of future interventions through public health strategies for eoCRC primary prevention. Additionally, we discussed the role of additional non-modifiable risk factors, and of epigenetic regulation and microbiota as mediators of the eoCRC triggered by diet and lifestyle.

• LINE-1
• antibiotics
• colorectal neoplasia
• epigenetics
• microbiota
• obesity
• risk factors
• smoking
• young

• Cancer Biogeography
• Colorectal Adenoma
• Colorectal Carcinogenesis
• FFQ
• Hydrogen Sulfide

• Adenomatous Polyps/diagnosis
• Adenomatous Polyps/epidemiology
• Adult
• Age of Onset
• Bacteria/metabolism
• Colonic Polyps/diagnosis
• Colonic Polyps/epidemiology
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/epidemiology
• Diet/adverse effects
• Female
• Gastrointestinal Microbiome
• Humans
• Hydrogen Sulfide/adverse effects
• Hydrogen Sulfide/metabolism
• Middle Aged
• Precancerous Conditions/diagnosis
• Precancerous Conditions/epidemiology
• Prospective Studies
• Risk Assessment
• Risk Factors
• Sulfur Compounds/administration & dosage
• Sulfur Compounds/adverse effects
• Sulfur Compounds/metabolism
• Time Factors
• United States/epidemiology

• R21 CA230873 NCI NIH HHS
• R01 CA202704 NCI NIH HHS
• U01 CA176726 NCI NIH HHS
• K23 DK125838 NIDDK NIH HHS
• R00 CA215314 NCI NIH HHS
• R35 CA253185 NCI NIH HHS
• R37 CA246175 NCI NIH HHS
• R21 CA222940 NCI NIH HHS
• R01 CA248857 NCI NIH HHS
• P30 DK043351 NIDDK NIH HHS
• R21 AA027608 NIAAA NIH HHS
• K07 CA218377 NCI NIH HHS
• R03 CA197879 NCI NIH HHS