Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review

Alexandra M. Zaborowski; Ahmed Abdile; Michel Adamina; Felix Aigner; Laura D'Allens; Caterina Allmer; Andrea Álvarez; Rocio Anula; Mihailo Andric; Sam Atallah; Simon Bach; Miklosh Bala; Marie Barussaud; Augustinas Bausys; Brendan Bebington; Andrew Beggs; Felipe Bellolio; Melissa-Rose Bennett; Anton Berdinskikh; Vicki Bevan; Sebastiano Biondo; Gabriele Bislenghi; Marc Bludau; Adam Boutall; Nelleke Brouwer; Carl Brown; Christiane Bruns; Daniel D. Buchanan; Pamela Buchwald; Jacobus W. A. Burger; Nikita Burlov; Michela Campanelli; Maylis Capdepont; Michele Carvello; Hwee-Hoon Chew; Dimitri Christoforidis; David Clark; Marta Climent; Kyle G. Cologne; Tomas Contreras; Roland Croner; Ian R. Daniels; Giovanni Dapri; Justin Davies; Paolo Delrio; Quentin Denost; Michael Deutsch; Andre Dias; André D'Hoore; Evgeniy Drozdov; Daniel Duek; Malcolm Dunlop; Adam Dziki; Aleksandra Edmundson; Sergey Efetov; Alaa el-Hussuna; Brodie Elliot; Sameh Emile; Eloy Espin; Martyn Evans; Seraina Faes; Omar Faiz; Fergal Fleming; Caterina Foppa; George Fowler; Matteo Frasson; Nuno Figueiredo; Tim Forgan; Frank Frizelle; Shamil Gadaev; Jose Gellona; Tamara Glyn; Jianping Gong; Barisic Goran; Emma Greenwood; Marianne G. Guren; Stephanie Guillon; Ida Gutlic; Dieter Hahnloser; Heather Hampel; Ann Hanly; Hirotoshi Hasegawa; Lene Hjerrild Iversen; Andrew Hill; James Hill; Jiri Hoch; Michael Hoffmeister; Roel Hompes; Luis Hurtado; Fabiano Iaquinandi; Ugne Imbrasaite; Rumana Islam; Mehrenah Dorna Jafari; Yukihide Kanemitsu; Aleksei Karachun; Ahmer A. Karimuddin; Deborah S. Keller; Justin Kelly; Rory Kennelly; Gleb Khrykov; Peter Kocian; Cherry Koh; Neils Kok; Katrina A. Knight; Joep Knol; Christos Kontovounisios; Hartwig Korner; Zoran Krivokapic; Irmgard Kronberger; Hidde Maarten Kroon; Marius Kryzauskas; Said Kural; Miranda Kusters; Zaher Lakkis; Timur Lankov; Dave Larson; György Lázár; Kai-Yin Lee; Suk Hwan Lee; J. rémie H. Lefèvre; Anna Lepisto; Christopher Lieu; Lynette Loi; Craig Lynch; Helene Maillou-Martinaud; Annalisa Maroli; Sean Martin; Anna Martling; Klaus E. Matzel; Julio Mayol; Frank McDermott; Guillaume Meurette; Monica Millan; Martin Mitteregger; Andrei Moiseenko; John R. T. Monson; Stefan Morarasu; Konosuke Moritani; Gabriela Möslein; Martino Munini; Caio Nahas; Sergio Nahas; Ionut Negoi; Anastasia Novikova; Misael Ocares; Koji Okabayashi; Alexandra Olkina; Luis Oñate-Ocaña; Jaime Otero; Cihan Ozen; Ugo Pace; Guilherme Pagin São Julião; Lidiia Panaiotti; Yves Panis; Demetris Papamichael; Jason Park; Swati Patel; Juan Carlos Patrón Uriburu; Miguel Pera; Rodrigo O. Perez; Alexei Petrov; Frank Pfeffer; P. Terry Phang; Tomas Poskus; Heather Pringle; David Proud; Ivana Raguz; Nuno Rama; Shahnawaz Rasheed; Manoj J. Raval; Daniela Rega; Christoph Reissfelder; Juan Carlos Reyes Meneses; Frederic Ris; Stefan Riss; Homero Rodriguez-Zentner; Campbell S. Roxburgh; Avanish Saklani; Andrea Jiménez Salido; Tarik Sammour; Deborah Saraste; Martin Schneider; Ryo Seishima; Aleksandar Sekulic; Toni Seppala; Kieran Sheahan; Rebecca Shine; Alexandra Shlomina; Guiseppe S. Sica; Tongplaew Singnomklao; Leandro Siragusa; Neil Smart; Alejandro Solis; Antonino Spinelli; Roxane D. Staiger; Michael J. Stamos; Scott Steele; Michael Sunderland; Ker-Kan Tan; Pieter J. Tanis; Paris Tekkis; Biniam Teklay; Sabrina Tengku; Marta Jiménez-Toscano; Petr Tsarkov; Matthias Turina; Alexis Ulrich; Bruna B. Vailati; Meike van Harten; Cornelis Verhoef; Satish Warrier; Steve Wexner; Hans de Wilt; Benjamin A. Weinberg; Cameron Wells; Albert Wolthuis; Evangelos Xynos; Nancy You; Alexander Zakharenko; Justino Zeballos; Des C. Winter

doi:https://doi.org/10.1001/jamasurg.2021.2380

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review

Alexandra M. Zaborowski, Ahmed Abdile, Michel Adamina, Felix Aigner, Laura D'Allens, Caterina Allmer, Andrea Álvarez, Rocio Anula, Mihailo Andric, Sam Atallah, Simon Bach, Miklosh Bala, Marie Barussaud, Augustinas Bausys, Brendan Bebington, Andrew Beggs, Felipe Bellolio, Melissa-Rose Bennett, Anton Berdinskikh, Vicki BevanSebastiano Biondo, Gabriele Bislenghi, Marc Bludau, Adam Boutall, Nelleke Brouwer, Carl Brown, Christiane Bruns, Daniel D. Buchanan, Pamela Buchwald, Jacobus W. A. Burger, Nikita Burlov, Michela Campanelli, Maylis Capdepont, Michele Carvello, Hwee-Hoon Chew, Dimitri Christoforidis, David Clark, Marta Climent, Kyle G. Cologne, Tomas Contreras, Roland Croner, Ian R. Daniels, Giovanni Dapri, Justin Davies, Paolo Delrio, Quentin Denost, Michael Deutsch, Andre Dias, André D'Hoore, Evgeniy Drozdov, Daniel Duek, Malcolm Dunlop, Adam Dziki, Aleksandra Edmundson, Sergey Efetov, Alaa el-Hussuna, Brodie Elliot, Sameh Emile, Eloy Espin, Martyn Evans, Seraina Faes, Omar Faiz, Fergal Fleming, Caterina Foppa, George Fowler, Matteo Frasson, Nuno Figueiredo, Tim Forgan, Frank Frizelle, Shamil Gadaev, Jose Gellona, Tamara Glyn, Jianping Gong, Barisic Goran, Emma Greenwood, Marianne G. Guren, Stephanie Guillon, Ida Gutlic, Dieter Hahnloser, Heather Hampel, Ann Hanly, Hirotoshi Hasegawa, Lene Hjerrild Iversen, Andrew Hill, James Hill, Jiri Hoch, Michael Hoffmeister, Roel Hompes, Luis Hurtado, Fabiano Iaquinandi, Ugne Imbrasaite, Rumana Islam, Mehrenah Dorna Jafari, Yukihide Kanemitsu, Aleksei Karachun, Ahmer A. Karimuddin, Deborah S. Keller, Justin Kelly, Rory Kennelly, Gleb Khrykov, Peter Kocian, Cherry Koh, Neils Kok, Katrina A. Knight, Joep Knol, Christos Kontovounisios, Hartwig Korner, Zoran Krivokapic, Irmgard Kronberger, Hidde Maarten Kroon, Marius Kryzauskas, Said Kural, Miranda Kusters, Zaher Lakkis, Timur Lankov, Dave Larson, György Lázár, Kai-Yin Lee, Suk Hwan Lee, J. rémie H. Lefèvre, Anna Lepisto, Christopher Lieu, Lynette Loi, Craig Lynch, Helene Maillou-Martinaud, Annalisa Maroli, Sean Martin, Anna Martling, Klaus E. Matzel, Julio Mayol, Frank McDermott, Guillaume Meurette, Monica Millan, Martin Mitteregger, Andrei Moiseenko, John R. T. Monson, Stefan Morarasu, Konosuke Moritani, Gabriela Möslein, Martino Munini, Caio Nahas, Sergio Nahas, Ionut Negoi, Anastasia Novikova, Misael Ocares, Koji Okabayashi, Alexandra Olkina, Luis Oñate-Ocaña, Jaime Otero, Cihan Ozen, Ugo Pace, Guilherme Pagin São Julião, Lidiia Panaiotti, Yves Panis, Demetris Papamichael, Jason Park, Swati Patel, Juan Carlos Patrón Uriburu, Miguel Pera, Rodrigo O. Perez, Alexei Petrov, Frank Pfeffer, P. Terry Phang, Tomas Poskus, Heather Pringle, David Proud, Ivana Raguz, Nuno Rama, Shahnawaz Rasheed, Manoj J. Raval, Daniela Rega, Christoph Reissfelder, Juan Carlos Reyes Meneses, Frederic Ris, Stefan Riss, Homero Rodriguez-Zentner, Campbell S. Roxburgh, Avanish Saklani, Andrea Jiménez Salido, Tarik Sammour, Deborah Saraste, Martin Schneider, Ryo Seishima, Aleksandar Sekulic, Toni Seppala, Kieran Sheahan, Rebecca Shine, Alexandra Shlomina, Guiseppe S. Sica, Tongplaew Singnomklao, Leandro Siragusa, Neil Smart, Alejandro Solis, Antonino Spinelli, Roxane D. Staiger, Michael J. Stamos, Scott Steele, Michael Sunderland, Ker-Kan Tan, Pieter J. Tanis, Paris Tekkis, Biniam Teklay, Sabrina Tengku, Marta Jiménez-Toscano, Petr Tsarkov, Matthias Turina, Alexis Ulrich, Bruna B. Vailati, Meike van Harten, Cornelis Verhoef, Satish Warrier, Steve Wexner, Hans de Wilt, Benjamin A. Weinberg, Cameron Wells, Albert Wolthuis, Evangelos Xynos, Nancy You, Alexander Zakharenko, Justino Zeballos, Des C. Winter

Research output: Contribution to journal › Review article › Academic › peer-review

104 Citations (Scopus)

Abstract

Importance: The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Observations: Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. Conclusions and Relevance: The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.

Original language	English
Pages (from-to)	865-874
Number of pages	10
Journal	Jama surgery
Volume	156
Issue number	9
DOIs	https://doi.org/10.1001/jamasurg.2021.2380
Publication status	Published - 1 Sept 2021

Access to Document

https://doi.org/10.1001/jamasurg.2021.2380

Cite this

Zaborowski, A. M., Abdile, A., Adamina, M., Aigner, F., D'Allens, L., Allmer, C., Álvarez, A., Anula, R., Andric, M., Atallah, S., Bach, S., Bala, M., Barussaud, M., Bausys, A., Bebington, B., Beggs, A., Bellolio, F., Bennett, M.-R., Berdinskikh, A., ... Winter, D. C. (2021). Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review. Jama surgery, 156(9), 865-874. https://doi.org/10.1001/jamasurg.2021.2380

@article{2f4cdec4583b44d4873a5cbfb5d8c461,

title = "Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review",

abstract = "Importance: The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Observations: Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. Conclusions and Relevance: The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.",

author = "Zaborowski, {Alexandra M.} and Ahmed Abdile and Michel Adamina and Felix Aigner and Laura D'Allens and Caterina Allmer and Andrea {\'A}lvarez and Rocio Anula and Mihailo Andric and Sam Atallah and Simon Bach and Miklosh Bala and Marie Barussaud and Augustinas Bausys and Brendan Bebington and Andrew Beggs and Felipe Bellolio and Melissa-Rose Bennett and Anton Berdinskikh and Vicki Bevan and Sebastiano Biondo and Gabriele Bislenghi and Marc Bludau and Adam Boutall and Nelleke Brouwer and Carl Brown and Christiane Bruns and Buchanan, {Daniel D.} and Pamela Buchwald and Burger, {Jacobus W. A.} and Nikita Burlov and Michela Campanelli and Maylis Capdepont and Michele Carvello and Hwee-Hoon Chew and Dimitri Christoforidis and David Clark and Marta Climent and Cologne, {Kyle G.} and Tomas Contreras and Roland Croner and Daniels, {Ian R.} and Giovanni Dapri and Justin Davies and Paolo Delrio and Quentin Denost and Michael Deutsch and Andre Dias and Andr{\'e} D'Hoore and Evgeniy Drozdov and Daniel Duek and Malcolm Dunlop and Adam Dziki and Aleksandra Edmundson and Sergey Efetov and Alaa el-Hussuna and Brodie Elliot and Sameh Emile and Eloy Espin and Martyn Evans and Seraina Faes and Omar Faiz and Fergal Fleming and Caterina Foppa and George Fowler and Matteo Frasson and Nuno Figueiredo and Tim Forgan and Frank Frizelle and Shamil Gadaev and Jose Gellona and Tamara Glyn and Jianping Gong and Barisic Goran and Emma Greenwood and Guren, {Marianne G.} and Stephanie Guillon and Ida Gutlic and Dieter Hahnloser and Heather Hampel and Ann Hanly and Hirotoshi Hasegawa and Iversen, {Lene Hjerrild} and Andrew Hill and James Hill and Jiri Hoch and Michael Hoffmeister and Roel Hompes and Luis Hurtado and Fabiano Iaquinandi and Ugne Imbrasaite and Rumana Islam and Jafari, {Mehrenah Dorna} and Yukihide Kanemitsu and Aleksei Karachun and Karimuddin, {Ahmer A.} and Keller, {Deborah S.} and Justin Kelly and Rory Kennelly and Gleb Khrykov and Peter Kocian and Cherry Koh and Neils Kok and Knight, {Katrina A.} and Joep Knol and Christos Kontovounisios and Hartwig Korner and Zoran Krivokapic and Irmgard Kronberger and Kroon, {Hidde Maarten} and Marius Kryzauskas and Said Kural and Miranda Kusters and Zaher Lakkis and Timur Lankov and Dave Larson and Gy{\"o}rgy L{\'a}z{\'a}r and Kai-Yin Lee and Lee, {Suk Hwan} and Lef{\`e}vre, {J. r{\'e}mie H.} and Anna Lepisto and Christopher Lieu and Lynette Loi and Craig Lynch and Helene Maillou-Martinaud and Annalisa Maroli and Sean Martin and Anna Martling and Matzel, {Klaus E.} and Julio Mayol and Frank McDermott and Guillaume Meurette and Monica Millan and Martin Mitteregger and Andrei Moiseenko and Monson, {John R. T.} and Stefan Morarasu and Konosuke Moritani and Gabriela M{\"o}slein and Martino Munini and Caio Nahas and Sergio Nahas and Ionut Negoi and Anastasia Novikova and Misael Ocares and Koji Okabayashi and Alexandra Olkina and Luis O{\~n}ate-Oca{\~n}a and Jaime Otero and Cihan Ozen and Ugo Pace and {S{\~a}o Juli{\~a}o}, {Guilherme Pagin} and Lidiia Panaiotti and Yves Panis and Demetris Papamichael and Jason Park and Swati Patel and {Patr{\'o}n Uriburu}, {Juan Carlos} and Miguel Pera and Perez, {Rodrigo O.} and Alexei Petrov and Frank Pfeffer and Phang, {P. Terry} and Tomas Poskus and Heather Pringle and David Proud and Ivana Raguz and Nuno Rama and Shahnawaz Rasheed and Raval, {Manoj J.} and Daniela Rega and Christoph Reissfelder and {Reyes Meneses}, {Juan Carlos} and Frederic Ris and Stefan Riss and Homero Rodriguez-Zentner and Roxburgh, {Campbell S.} and Avanish Saklani and Salido, {Andrea Jim{\'e}nez} and Tarik Sammour and Deborah Saraste and Martin Schneider and Ryo Seishima and Aleksandar Sekulic and Toni Seppala and Kieran Sheahan and Rebecca Shine and Alexandra Shlomina and Sica, {Guiseppe S.} and Tongplaew Singnomklao and Leandro Siragusa and Neil Smart and Alejandro Solis and Antonino Spinelli and Staiger, {Roxane D.} and Stamos, {Michael J.} and Scott Steele and Michael Sunderland and Ker-Kan Tan and Tanis, {Pieter J.} and Paris Tekkis and Biniam Teklay and Sabrina Tengku and Marta Jim{\'e}nez-Toscano and Petr Tsarkov and Matthias Turina and Alexis Ulrich and Vailati, {Bruna B.} and {van Harten}, Meike and Cornelis Verhoef and Satish Warrier and Steve Wexner and {de Wilt}, Hans and Weinberg, {Benjamin A.} and Cameron Wells and Albert Wolthuis and Evangelos Xynos and Nancy You and Alexander Zakharenko and Justino Zeballos and Winter, {Des C.}",

note = "Funding Information: reported grants from Medical Research Council South Africa as part of a Medical Research Council CURE grant and personal fees from Wits Consortium Salary as a past head of colorectal surgery during the conduct of the study; also, as a researcher in the developing world, Dr Bebington is constantly seeking opportunities to collaborate with institutions such as the Sloan Kettering, which has not unduly affected the honesty of data provided for the research nor the contribution he has made to intellectual content but could be construed as such. Dr Bruns reported personal fees from Medtronic as an advisory board member and Promedicis for Excellence in Oncology and grants from Intuitive for the ESOMAP trial and SIRTex for the ESSURE registry outside the submitted work. Dr Daniels reported personal fees from Origin Sciences, where he is a chief medical officer, appointed in August 2020; personal fees from Medtronic/Covidien and BD/Bard for teaching and advising; and nonfinancial support from Colostomy UK as honorary president of a charity focused on support for people with stomas, outside the submitted work. Dr Dunlop reported grants from University of Edinburgh during the conduct of the study. Dr Fleming reported author royalties from UptoDate outside the submitted work. Dr Frasson reported personal fees from J&J Consultory outside the submitted work. Dr Figueiredo reported personal fees for consulting and lectures from Johnson & Johnson outside the submitted work. Dr Frizelle reported serving as the editor of another Journal. Dr Hampel reported advisory board membership with Invitae Scientific, Genome Medical Scientific, and Promega Scientific outside the submitted work. Dr Karimuddin reported speaker{\textquoteright}s fees from Servier outside the submitted work. Dr Lynch reported proctoring fees from Device Technologies and honoraria from Stryker outside the submitted work. Dr Mayol reported personal fees from Novartis, Boehringer Ingelheim, Astellas, Rovi, SOBI, Shionogi, Alcon, Roche, and Johnson & Johnson outside the submitted work. Dr S{\~a}o Juli{\~a}o reported personal fees from Johnson and Johnson, Roche, and Merck Sharp & Dohme outside the submitted work. Dr Pfeffer reported a research grant from Intuitive Surgical outside the submitted work. Dr Ris reported personal fees from Arthrex, Distal Motion, and Stryker and grants from Quantgene outside the submitted work. Dr Saraste reported grants from Bengt Ihre Foundation and Mag-Tarmfonden during the conduct of the study. Dr Sepp{\"a}l{\"a} reported being the CEO and co-owner from Healthfund Finland Ltd and interview honoraria from Boehringer Ingelheim Finland outside the submitted work. Dr Smart reported personal fees (speaker{\textquoteright}s fees for hernia surgery) from Medtronic and WL Gore outside the submitted work. Dr Spinelli reported personal fees from Ethicon, Takeda, Janssen, Sofar, and Oasis outside the submitted work. Dr Tanis reported grants from LifeCell and Allergan outside the submitted work. Dr Vailati reported personal fees from Medtronic and Johnson & Johnson outside the submitted work. Dr Wexner reported consulting fees from Intuitive Surgical, Stryker, Medtronic, Tigenix, Axonics, Baxter, LiCor, and AISChannel; stock options from Regentys, LifeBond, Pragma, and Renew Medical; royalties from Medtronic, Intuitive Surgical, Karl Storz Endoscopy America, and Unique Surgical Innovations; and inactive consulting relationships with CRH Medical and Intuitive Surgical. Dr de Wilt reported grants from Dutch Cancer Society, ZonMW (The Netherlands Organisation for Health Research and Development), Bergh in het Zadel Foundation, and Medtronic to his institution outside the submitted work. No other disclosures were reported. Publisher Copyright: {\textcopyright} 2021 American Medical Association. All rights reserved.",

year = "2021",

month = sep,

day = "1",

doi = "https://doi.org/10.1001/jamasurg.2021.2380",

language = "English",

volume = "156",

pages = "865--874",

journal = "Jama surgery",

issn = "2168-6254",

publisher = "American Medical Association",

number = "9",

}

Zaborowski, AM, Abdile, A, Adamina, M, Aigner, F, D'Allens, L, Allmer, C, Álvarez, A, Anula, R, Andric, M, Atallah, S, Bach, S, Bala, M, Barussaud, M, Bausys, A, Bebington, B, Beggs, A, Bellolio, F, Bennett, M-R, Berdinskikh, A, Bevan, V, Biondo, S, Bislenghi, G, Bludau, M, Boutall, A, Brouwer, N, Brown, C, Bruns, C, Buchanan, DD, Buchwald, P, Burger, JWA, Burlov, N, Campanelli, M, Capdepont, M, Carvello, M, Chew, H-H, Christoforidis, D, Clark, D, Climent, M, Cologne, KG, Contreras, T, Croner, R, Daniels, IR, Dapri, G, Davies, J, Delrio, P, Denost, Q, Deutsch, M, Dias, A, D'Hoore, A, Drozdov, E, Duek, D, Dunlop, M, Dziki, A, Edmundson, A, Efetov, S, el-Hussuna, A, Elliot, B, Emile, S, Espin, E, Evans, M, Faes, S, Faiz, O, Fleming, F, Foppa, C, Fowler, G, Frasson, M, Figueiredo, N, Forgan, T, Frizelle, F, Gadaev, S, Gellona, J, Glyn, T, Gong, J, Goran, B, Greenwood, E, Guren, MG, Guillon, S, Gutlic, I, Hahnloser, D, Hampel, H, Hanly, A, Hasegawa, H, Iversen, LH, Hill, A, Hill, J, Hoch, J, Hoffmeister, M, Hompes, R, Hurtado, L, Iaquinandi, F, Imbrasaite, U, Islam, R, Jafari, MD, Kanemitsu, Y, Karachun, A, Karimuddin, AA, Keller, DS, Kelly, J, Kennelly, R, Khrykov, G, Kocian, P, Koh, C, Kok, N, Knight, KA, Knol, J, Kontovounisios, C, Korner, H, Krivokapic, Z, Kronberger, I, Kroon, HM, Kryzauskas, M, Kural, S, Kusters, M, Lakkis, Z, Lankov, T, Larson, D, Lázár, G, Lee, K-Y, Lee, SH, Lefèvre, JRH, Lepisto, A, Lieu, C, Loi, L, Lynch, C, Maillou-Martinaud, H, Maroli, A, Martin, S, Martling, A, Matzel, KE, Mayol, J, McDermott, F, Meurette, G, Millan, M, Mitteregger, M, Moiseenko, A, Monson, JRT, Morarasu, S, Moritani, K, Möslein, G, Munini, M, Nahas, C, Nahas, S, Negoi, I, Novikova, A, Ocares, M, Okabayashi, K, Olkina, A, Oñate-Ocaña, L, Otero, J, Ozen, C, Pace, U, São Julião, GP, Panaiotti, L, Panis, Y, Papamichael, D, Park, J, Patel, S, Patrón Uriburu, JC, Pera, M, Perez, RO, Petrov, A, Pfeffer, F, Phang, PT, Poskus, T, Pringle, H, Proud, D, Raguz, I, Rama, N, Rasheed, S, Raval, MJ, Rega, D, Reissfelder, C, Reyes Meneses, JC, Ris, F, Riss, S, Rodriguez-Zentner, H, Roxburgh, CS, Saklani, A, Salido, AJ, Sammour, T, Saraste, D, Schneider, M, Seishima, R, Sekulic, A, Seppala, T, Sheahan, K, Shine, R, Shlomina, A, Sica, GS, Singnomklao, T, Siragusa, L, Smart, N, Solis, A, Spinelli, A, Staiger, RD, Stamos, MJ, Steele, S, Sunderland, M, Tan, K-K, Tanis, PJ, Tekkis, P, Teklay, B, Tengku, S, Jiménez-Toscano, M, Tsarkov, P, Turina, M, Ulrich, A, Vailati, BB, van Harten, M, Verhoef, C, Warrier, S, Wexner, S, de Wilt, H, Weinberg, BA, Wells, C, Wolthuis, A, Xynos, E, You, N, Zakharenko, A, Zeballos, J & Winter, DC 2021, 'Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review', Jama surgery, vol. 156, no. 9, pp. 865-874. https://doi.org/10.1001/jamasurg.2021.2380

TY - JOUR

T1 - Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review

AU - Zaborowski, Alexandra M.

AU - Abdile, Ahmed

AU - Adamina, Michel

AU - Aigner, Felix

AU - D'Allens, Laura

AU - Allmer, Caterina

AU - Álvarez, Andrea

AU - Anula, Rocio

AU - Andric, Mihailo

AU - Atallah, Sam

AU - Bach, Simon

AU - Bala, Miklosh

AU - Barussaud, Marie

AU - Bausys, Augustinas

AU - Bebington, Brendan

AU - Beggs, Andrew

AU - Bellolio, Felipe

AU - Bennett, Melissa-Rose

AU - Berdinskikh, Anton

AU - Bevan, Vicki

AU - Biondo, Sebastiano

AU - Bislenghi, Gabriele

AU - Bludau, Marc

AU - Boutall, Adam

AU - Brouwer, Nelleke

AU - Brown, Carl

AU - Bruns, Christiane

AU - Buchanan, Daniel D.

AU - Buchwald, Pamela

AU - Burger, Jacobus W. A.

AU - Burlov, Nikita

AU - Campanelli, Michela

AU - Capdepont, Maylis

AU - Carvello, Michele

AU - Chew, Hwee-Hoon

AU - Christoforidis, Dimitri

AU - Clark, David

AU - Climent, Marta

AU - Cologne, Kyle G.

AU - Contreras, Tomas

AU - Croner, Roland

AU - Daniels, Ian R.

AU - Dapri, Giovanni

AU - Davies, Justin

AU - Delrio, Paolo

AU - Denost, Quentin

AU - Deutsch, Michael

AU - Dias, Andre

AU - D'Hoore, André

AU - Drozdov, Evgeniy

AU - Duek, Daniel

AU - Dunlop, Malcolm

AU - Dziki, Adam

AU - Edmundson, Aleksandra

AU - Efetov, Sergey

AU - el-Hussuna, Alaa

AU - Elliot, Brodie

AU - Emile, Sameh

AU - Espin, Eloy

AU - Evans, Martyn

AU - Faes, Seraina

AU - Faiz, Omar

AU - Fleming, Fergal

AU - Foppa, Caterina

AU - Fowler, George

AU - Frasson, Matteo

AU - Figueiredo, Nuno

AU - Forgan, Tim

AU - Frizelle, Frank

AU - Gadaev, Shamil

AU - Gellona, Jose

AU - Glyn, Tamara

AU - Gong, Jianping

AU - Goran, Barisic

AU - Greenwood, Emma

AU - Guren, Marianne G.

AU - Guillon, Stephanie

AU - Gutlic, Ida

AU - Hahnloser, Dieter

AU - Hampel, Heather

AU - Hanly, Ann

AU - Hasegawa, Hirotoshi

AU - Iversen, Lene Hjerrild

AU - Hill, Andrew

AU - Hill, James

AU - Hoch, Jiri

AU - Hoffmeister, Michael

AU - Hompes, Roel

AU - Hurtado, Luis

AU - Iaquinandi, Fabiano

AU - Imbrasaite, Ugne

AU - Islam, Rumana

AU - Jafari, Mehrenah Dorna

AU - Kanemitsu, Yukihide

AU - Karachun, Aleksei

AU - Karimuddin, Ahmer A.

AU - Keller, Deborah S.

AU - Kelly, Justin

AU - Kennelly, Rory

AU - Khrykov, Gleb

AU - Kocian, Peter

AU - Koh, Cherry

AU - Kok, Neils

AU - Knight, Katrina A.

AU - Knol, Joep

AU - Kontovounisios, Christos

AU - Korner, Hartwig

AU - Krivokapic, Zoran

AU - Kronberger, Irmgard

AU - Kroon, Hidde Maarten

AU - Kryzauskas, Marius

AU - Kural, Said

AU - Kusters, Miranda

AU - Lakkis, Zaher

AU - Lankov, Timur

AU - Larson, Dave

AU - Lázár, György

AU - Lee, Kai-Yin

AU - Lee, Suk Hwan

AU - Lefèvre, J. rémie H.

AU - Lepisto, Anna

AU - Lieu, Christopher

AU - Loi, Lynette

AU - Lynch, Craig

AU - Maillou-Martinaud, Helene

AU - Maroli, Annalisa

AU - Martin, Sean

AU - Martling, Anna

AU - Matzel, Klaus E.

AU - Mayol, Julio

AU - McDermott, Frank

AU - Meurette, Guillaume

AU - Millan, Monica

AU - Mitteregger, Martin

AU - Moiseenko, Andrei

AU - Monson, John R. T.

AU - Morarasu, Stefan

AU - Moritani, Konosuke

AU - Möslein, Gabriela

AU - Munini, Martino

AU - Nahas, Caio

AU - Nahas, Sergio

AU - Negoi, Ionut

AU - Novikova, Anastasia

AU - Ocares, Misael

AU - Okabayashi, Koji

AU - Olkina, Alexandra

AU - Oñate-Ocaña, Luis

AU - Otero, Jaime

AU - Ozen, Cihan

AU - Pace, Ugo

AU - São Julião, Guilherme Pagin

AU - Panaiotti, Lidiia

AU - Panis, Yves

AU - Papamichael, Demetris

AU - Park, Jason

AU - Patel, Swati

AU - Patrón Uriburu, Juan Carlos

AU - Pera, Miguel

AU - Perez, Rodrigo O.

AU - Petrov, Alexei

AU - Pfeffer, Frank

AU - Phang, P. Terry

AU - Poskus, Tomas

AU - Pringle, Heather

AU - Proud, David

AU - Raguz, Ivana

AU - Rama, Nuno

AU - Rasheed, Shahnawaz

AU - Raval, Manoj J.

AU - Rega, Daniela

AU - Reissfelder, Christoph

AU - Reyes Meneses, Juan Carlos

AU - Ris, Frederic

AU - Riss, Stefan

AU - Rodriguez-Zentner, Homero

AU - Roxburgh, Campbell S.

AU - Saklani, Avanish

AU - Salido, Andrea Jiménez

AU - Sammour, Tarik

AU - Saraste, Deborah

AU - Schneider, Martin

AU - Seishima, Ryo

AU - Sekulic, Aleksandar

AU - Seppala, Toni

AU - Sheahan, Kieran

AU - Shine, Rebecca

AU - Shlomina, Alexandra

AU - Sica, Guiseppe S.

AU - Singnomklao, Tongplaew

AU - Siragusa, Leandro

AU - Smart, Neil

AU - Solis, Alejandro

AU - Spinelli, Antonino

AU - Staiger, Roxane D.

AU - Stamos, Michael J.

AU - Steele, Scott

AU - Sunderland, Michael

AU - Tan, Ker-Kan

AU - Tanis, Pieter J.

AU - Tekkis, Paris

AU - Teklay, Biniam

AU - Tengku, Sabrina

AU - Jiménez-Toscano, Marta

AU - Tsarkov, Petr

AU - Turina, Matthias

AU - Ulrich, Alexis

AU - Vailati, Bruna B.

AU - van Harten, Meike

AU - Verhoef, Cornelis

AU - Warrier, Satish

AU - Wexner, Steve

AU - de Wilt, Hans

AU - Weinberg, Benjamin A.

AU - Wells, Cameron

AU - Wolthuis, Albert

AU - Xynos, Evangelos

AU - You, Nancy

AU - Zakharenko, Alexander

AU - Zeballos, Justino

AU - Winter, Des C.

N1 - Funding Information: reported grants from Medical Research Council South Africa as part of a Medical Research Council CURE grant and personal fees from Wits Consortium Salary as a past head of colorectal surgery during the conduct of the study; also, as a researcher in the developing world, Dr Bebington is constantly seeking opportunities to collaborate with institutions such as the Sloan Kettering, which has not unduly affected the honesty of data provided for the research nor the contribution he has made to intellectual content but could be construed as such. Dr Bruns reported personal fees from Medtronic as an advisory board member and Promedicis for Excellence in Oncology and grants from Intuitive for the ESOMAP trial and SIRTex for the ESSURE registry outside the submitted work. Dr Daniels reported personal fees from Origin Sciences, where he is a chief medical officer, appointed in August 2020; personal fees from Medtronic/Covidien and BD/Bard for teaching and advising; and nonfinancial support from Colostomy UK as honorary president of a charity focused on support for people with stomas, outside the submitted work. Dr Dunlop reported grants from University of Edinburgh during the conduct of the study. Dr Fleming reported author royalties from UptoDate outside the submitted work. Dr Frasson reported personal fees from J&J Consultory outside the submitted work. Dr Figueiredo reported personal fees for consulting and lectures from Johnson & Johnson outside the submitted work. Dr Frizelle reported serving as the editor of another Journal. Dr Hampel reported advisory board membership with Invitae Scientific, Genome Medical Scientific, and Promega Scientific outside the submitted work. Dr Karimuddin reported speaker’s fees from Servier outside the submitted work. Dr Lynch reported proctoring fees from Device Technologies and honoraria from Stryker outside the submitted work. Dr Mayol reported personal fees from Novartis, Boehringer Ingelheim, Astellas, Rovi, SOBI, Shionogi, Alcon, Roche, and Johnson & Johnson outside the submitted work. Dr São Julião reported personal fees from Johnson and Johnson, Roche, and Merck Sharp & Dohme outside the submitted work. Dr Pfeffer reported a research grant from Intuitive Surgical outside the submitted work. Dr Ris reported personal fees from Arthrex, Distal Motion, and Stryker and grants from Quantgene outside the submitted work. Dr Saraste reported grants from Bengt Ihre Foundation and Mag-Tarmfonden during the conduct of the study. Dr Seppälä reported being the CEO and co-owner from Healthfund Finland Ltd and interview honoraria from Boehringer Ingelheim Finland outside the submitted work. Dr Smart reported personal fees (speaker’s fees for hernia surgery) from Medtronic and WL Gore outside the submitted work. Dr Spinelli reported personal fees from Ethicon, Takeda, Janssen, Sofar, and Oasis outside the submitted work. Dr Tanis reported grants from LifeCell and Allergan outside the submitted work. Dr Vailati reported personal fees from Medtronic and Johnson & Johnson outside the submitted work. Dr Wexner reported consulting fees from Intuitive Surgical, Stryker, Medtronic, Tigenix, Axonics, Baxter, LiCor, and AISChannel; stock options from Regentys, LifeBond, Pragma, and Renew Medical; royalties from Medtronic, Intuitive Surgical, Karl Storz Endoscopy America, and Unique Surgical Innovations; and inactive consulting relationships with CRH Medical and Intuitive Surgical. Dr de Wilt reported grants from Dutch Cancer Society, ZonMW (The Netherlands Organisation for Health Research and Development), Bergh in het Zadel Foundation, and Medtronic to his institution outside the submitted work. No other disclosures were reported. Publisher Copyright: © 2021 American Medical Association. All rights reserved.

PY - 2021/9/1

Y1 - 2021/9/1

N2 - Importance: The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Observations: Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. Conclusions and Relevance: The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.

AB - Importance: The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Observations: Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. Conclusions and Relevance: The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.

UR - http://www.scopus.com/inward/record.url?scp=85114982910&partnerID=8YFLogxK

U2 - https://doi.org/10.1001/jamasurg.2021.2380

DO - https://doi.org/10.1001/jamasurg.2021.2380

M3 - Review article

C2 - 34190968

SN - 2168-6254

VL - 156

SP - 865

EP - 874

JO - Jama surgery

JF - Jama surgery

IS - 9

ER -

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review

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