Young-onset colorectal cancer.
Manon C W SpaanderAnn G ZauberSapna SyngalMartin J BlaserJoseph Jao Yiu SungY Nancy YouErnst J KuipersPublished in: Nature reviews. Disease primers (2023)
In the past decades the incidence of colorectal cancer (CRC) in people under the age of 50 years has increased, which is referred to as early-onset CRC or young-onset CRC (YO-CRC). YO-CRC is expected to account for 11% of colon cancers and 23% of rectal cancers by 2030. This trend is observed in different parts of the world and in both men and women. In 20% of patients with YO-CRC, a hereditary cancer syndrome is found as the underlying cause; however, in the majority of patients no genetic predisposition is present. Beginning in the 1950s, major changes in lifestyle such as antibiotic use, low physical activity and obesity have affected the gut microbiome and may be an important factor in YO-CRC development. Owing to a lack of screening, patients with YO-CRC are often diagnosed with advanced-stage disease. Long-term treatment-related complications should be taken into account in these younger patients, making the more traditional sequential approaches of drug therapy not always the most appropriate option. To better understand the underlying mechanism and define relationships between environmental factors and YO-CRC development, long-term prospective studies are needed with lifestyle data collected from childhood.
Keyphrases
- physical activity
- early onset
- end stage renal disease
- metabolic syndrome
- newly diagnosed
- ejection fraction
- weight loss
- cardiovascular disease
- chronic kidney disease
- body mass index
- prognostic factors
- stem cells
- peritoneal dialysis
- insulin resistance
- patient reported
- squamous cell
- depressive symptoms
- gene expression
- young adults
- rectal cancer
- machine learning
- sleep quality
- genome wide
- bone marrow
- drug induced
- combination therapy
- case report
- artificial intelligence