Early-onset colorectal cancer: Current insights and future directions

Abstract

Early-onset colorectal cancer (EOCRC) has seen an alarming rise worldwide over the past two decades. The reason for this global trend is poorly understood. EOCRC appears to have its own unique clinical and molecular features when compared with late-onset colorectal cancer. Younger patients appear to have more distal or rectal disease, a more advanced stage of disease at presentation, and more unfavorable histological features. Identifying risk factors for EOCRC is the first step in mitigating the rising burden of this disease. Here we summarize several noteworthy biological factors and environmental exposures that are postulated to be responsible culprits. This can hopefully translate in clinical practice to the development of better risk stratification tool for identifying high-risk individuals for early colorectal cancer screening, and identifying areas needed for further research to curb this rising trend.

Keywords: Early-onset colorectal cancer; Young-onset colorectal cancer; Risk factors; Environmental exposures; Microbiome; Genetics

Core Tip: The incidence of early onset colorectal cancer is on the rise. Herein, we discuss on various risk factors that have been implicated for these recent trends and point to where future research needs to be directed for better utilization of healthcare resources. Early recognition and diagnosis are essential for better outcomes of this preventable cancer.