Early-onset Colorectal Cancer is Distinct From Traditional Colorectal Cancer

Yeo, Heather; Betel, Doron; Abelson, Jonathan S.; Zheng, Xi; Yantiss, Rhonda K.; Shah, Manish A.

doi:10.1016/j.clcc.2017.06.002

Cited by 122 publications

(114 citation statements)

References 29 publications

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“…Collectively, these findings suggest that the rising proportion of CRC cases seen in young adults may stem from access to health care resources (primarily screening) as well as lifestyle factors such as obesity 23 and meat consumption. 17,[28][29][30] Cases diagnosed at an age younger than 45 years were clinically similar to those diagnosed between the ages of 45 and 49 years. One previously proposed explanation for the rising incidence of CRC in younger adults is that instead of a true increase in incidence rates, the increasing use of colonoscopy has merely increased the lead-time bias.…”

Section: Resultsmentioning

confidence: 64%

“…For both sexes, the highest proportion of young cases was found in Hispanic whites, who were followed by Asians, then African Americans, and lastly non-Hispanic whites. The high proportion of young cases among Hispanic whites is directly due to the younger age of the Hispanic population in the United States, 17 whereas young-onset CRC has been previously recognized in African American patients. 18 However, the high rate of CRC cases diagnosed before the age of 50 years in Asian populations is not well represented in the previous literature and may warrant future study.…”

Section: Discussionmentioning

confidence: 99%

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Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015

Virostko

Capasso

Yankeelov

et al. 2019

Cancer

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BACKGROUND: The incidence of colorectal cancer (CRC) in adults younger than 50 years has increased in the United States over the past decades according to Surveillance, Epidemiology, and End Results data. National guidelines conflict over beginning screening at the age of 45 or 50 years. METHODS: This was a retrospective study of National Cancer Data Base data from 2004 to 2015. The Cochran-Armitage test for trend was used to assess changes in the proportion of cases diagnosed at an age younger than 50 years. RESULTS: This study identified 130,165 patients diagnosed at an age younger than 50 years and 1,055,598 patients diagnosed at the age of 50 years or older. The proportion of the total number of patients diagnosed with CRC at an age younger than 50 years rose (12.2% in 2015 vs 10.0% in 2004; P < .0001). Younger adults presented with more advanced disease (stage III/IV; 51.6% vs 40.0% of those 50 years old or older). Among men, diagnosis at ages younger than 50 years rose only in non-Hispanic whites (P < .0001), whereas among women, Hispanic and non-Hispanic whites had increases in younger diagnoses over time (P < .05). All income quartiles had a proportional increase in younger adults over time (P < .001), with the highest income quartile having the highest proportion of younger cases. The proportion of younger onset CRC cases rose in urban areas (P < .001) but did not rise in rural areas. CONCLUSIONS: The proportion of persons diagnosed with CRC at an age younger than 50 years in the United States has continued to increase over the past decade, and younger adults present with more advanced disease. These data should be considered in the ongoing discussion of screening guidelines. Cancer 2019;125:3828-3835.

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Section: Resultsmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015

Virostko

Capasso

Yankeelov

et al. 2019

Cancer

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“…Approximately 4 in 10 individuals with early‐onset disease have a family history of CRC or a risk‐inducing genetic mutation and thus, their elevated risk is potentially identifiable, whereas the remaining 60% are labeled “sporadic.” Various traditional CRC risk factors likely are contributing to the upward trend in early‐onset disease, including the obesity epidemic, the increasing prevalence of type II diabetes mellitus, a rise in sedentary lifestyle, and higher consumption of processed and red meats in the under 50 population . In addition to these risk factors, recent studies suggest that many sporadic cases of early‐onset CRC have features that differentiate them clinically, pathologically, and molecularly from traditional cases of CRC diagnosed in older individuals . Efforts are underway to better characterize these distinguishing features, understand the interplay between molecular‐genetic factors and environmental/behavioral risks, and use this information to enhance risk assessment and intervention.…”

Section: Screening and Surveillance For The Early Detection Of Adenommentioning

confidence: 99%

“…47 In addition to these risk factors, recent studies suggest that many sporadic cases of early-onset CRC have features that differentiate them clinically, pathologically, and molecularly from traditional cases of CRC diagnosed in older individuals. 66,67 Efforts are underway to better characterize these distinguishing features, understand the interplay between molecular-genetic factors and environmental/behavioral risks, and use this information to enhance risk assessment and intervention.…”

Section: Crc Trends In Younger Individualsmentioning

confidence: 99%

Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening

Smith

Andrews

Brooks

et al. 2018

CA A Cancer J Clinicians

423

319

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Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates from the National Health Interview Survey, and select issues related to cancer screening. In this 2018 update, we also summarize the new American Cancer Society colorectal cancer screening guideline and include a clarification in the language of the 2013 lung cancer screening guideline. CA Cancer J Clin 2018;68:297-316. © 2018 American Cancer Society.

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“…Diagnosis of metachronous and/or synchronous MN was defined according to the international association of cancer registry rules [32]. EO of cancer was defined for each primary tumor as follows: for NSCLC ≤60 years [33], for kidney cancer ≤46 years [34], for urothelial cancer ≤40 years [35][36][37], for melanoma ≤39 years [38,39], for colorectal cancer <50 years [40] and <45 years for head and neck carcinomas [41]. renal cell carcinoma 41 patients (19.4%), melanoma 51 patients (24.2%), NSCLC 104 patients (49.3%), urothelial cancer 10 patients (4.7%), colorectal cancer three patients (1.4%) and head and neck carcinomas two patients (1%).…”

Section: Definition Of Family History Of Cancer Multiple Neoplasms Andmentioning

confidence: 99%

Family History of Cancer as Surrogate Predictor for Immunotherapy with Anti-Pd1/Pd-L1 Agents: Preliminary Report of the Fami-L1 Study

et al. 2018

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Aim: Tumors related to hereditary susceptibility seem to have an immunosensitive phenotype. Materials & methods : We conducted a multicenter retrospective study, to investigate if family history of cancer, multiple neoplasms and early onset of cancer could be related to clinical outcomes of anti-PD-1/PD-L1 therapy. Activity and efficacy data of 211 advanced cancer patients (kidney, non-small-cell lung cancer, melanoma, urothelium, colorectal and HeN), treated at seven Italian centers with anti-PD-1/PD-L1 agents, were analyzed. Results: In this preliminary report at multivariate analyses, positive family history of cancer showed a statistically significant relationship with a better objective response rate (p = 0.0024), disease control rate (p = 0.0161), median time to treatment failure (p = 0.0203) and median overall survival (p = 0.0221). Diagnosis of multiple neoplasms significantly correlates only to a better disease control rate, while interestingly non-early onset of cancer and sex (in favor of female patients) showed significant correlation with a better median overall survival (p = 0.0268 and p = 0.0272, respectively). Conclusion: This pilot study seems to individuate easily available patient's features as possible predictive surrogates of clinical benefit for anti-PD-1/PD-L1 treatments. These preliminary results need to be confirmed with a greater sample size, in prospective trials with immunotherapy.

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Early-onset Colorectal Cancer is Distinct From Traditional Colorectal Cancer

Cited by 122 publications

References 29 publications

Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015

Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015

Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening

Family History of Cancer as Surrogate Predictor for Immunotherapy with Anti-Pd1/Pd-L1 Agents: Preliminary Report of the Fami-L1 Study

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