The risk of young-onset colorectal adenomas and cancer (yCRAC) in adults less than 50 years of age is increasing. We conducted a systematic review and meta-analysis of epidemiologic studies to identify lifestyle and clinical risk factors associated with yCRAC risk. We searched Medline, EMBASE, and Cochrane Database of Systematic Reviews for studies which: used an epidemiologic study design, involved individuals with yCRAC, evaluated at least 1 lifestyle or clinical factor, and applied multivariable regression approaches. We critically appraised the quality of included studies and calculated pooled measures of association (e.g. odds ratio [OR]) and 95% confidence intervals (CI) using random-effects models. We identified 499 articles in our search with 9 included in a narrative synthesis and 6 included in a meta-analysis. We found in the pooled analysis that smoking and alcohol consumption were lifestyle factors associated with yCRAC, as were clinical factors including obesity elevated blood glucose, elevated blood pressure, and elevated triglycerides. We identified lifestyle and clinical risk factors associated with risk of yCRAC, which have potential implications for informing preventive efforts and modifying screening to target at-risk populations.

Objective: The aim of this study was to gain a better understanding of the lived experiences of young-onset colorectal cancer (yCRC) from the perspective of patients and/or caregivers. Methods: We conducted a qualitative study, in collaboration with COLONTOWN®, an online colorectal cancer community. Individuals who have been diagnosed with yCRC, that is below the age of 50 years, or care for an individual with yCRC were invited to complete an online survey primarily comprising of an open-ended question asking participants to share their yCRC experiences in a text box, similar with how they may post on a social media platform. We applied an inductive, qualitative approach to identify themes arising from participants’ experiences. Results: From May to June 2019, we gathered experiences from 109 patients with yCRC and 11 caregivers. The majority of patients with yCRC were female (86, 71.7%) and diagnosed between the ages of 30 and 39 (49, 40.9%) and 40 and 49 years (61, 50.8%). We identified 8 themes: symptoms experienced; being misdiagnosed; advocating for oneself; appreciation of the healthcare team; frustration with the healthcare team and healthcare system; lasting effects of yCRC and its treatment; connecting with others; and reflections on experiences with yCRC. Conclusions: Our study highlights challenges experienced by yCRC patients across diagnosis, during treatment, and after treatment, notably misdiagnosis and need for access to information and support. Our study raises awareness of yCRC and experiences of individuals impacted by this disease.

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Primary care providers are the main point of contact with the healthcare system for individuals with intellectual disability, and they may have pre-existing attitudes towards this group that impacts care. We examined whether participants’ gender, age, professional status and experience with individuals with intellectual disability were associated with attitudes by surveying 95 family physicians, family medicine trainees and advanced practice nursing students across a Canadian province. Younger participants were more likely to feel that those with intellectual disability are similar to themselves and that individuals with intellectual disability should be empowered to take control of their lives. Older participants were more likely to believe that individuals with intellectual disability are vulnerable. These findings suggest there may be a generational difference in attitudes, and educational interventions may be needed to ameliorate attitudes among older primary care providers to reduce the impact of pre-existing attitudes on the provision of care.