Early‐onset colorectal cancer in young individuals

• Published in: Molecular oncology Vol. 13; no. 2; pp. 109 - 131
• Main Authors: Mauri, Gianluca, Sartore‐Bianchi, Andrea, Russo, Antonio‐Giampiero, Marsoni, Silvia, Bardelli, Alberto, Siena, Salvatore
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.02.2019; John Wiley and Sons Inc; Wiley
• Subjects: Adult; Age Factors; Age groups; Age of Onset; Blood tests; Cancer; Cancer therapies; Care and treatment; Cell differentiation; Clinical trials; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - genetics; Colorectal Neoplasms - therapy; Diagnosis; Epidemiology; familial colorectal cancer; Genetic Predisposition to Disease; Geography; Grants; hereditary colorectal cancer; Humans; Incidence; Medical prognosis; Metastasis; Mortality; Mutation; Mutation - genetics; Oncology; Patients; Prognosis; Review; Risk Factors; SEER Program; sporadic early‐onset colorectal cancer; Systematic review; Tumors; Women; Young Adult; Young adults; United States > US; Europe; sporadic early-onset colorectal cancer; colorectal cancer; young adults; familial colorectal cancer; hereditary colorectal cancer
• ISSN: 1574-7891; 1878-0261; 1878-0261
• DOI: 10.1002/1878-0261.12417

Treatment of young adults with colorectal cancer (CRC) represents an unmet clinical need, especially as diagnosis in this population might lead to the greatest loss of years of life. Since 1994, CRC incidence in individuals younger than 50 years has been increasing by 2% per year. The surge in CRC incidence in young adults is particularly alarming as the overall CRC frequency has been decreasing. Early‐onset CRC are characterized by a more advanced stage at diagnosis, poorer cell differentiation, higher prevalence of signet ring cell histology, and left colon‐sided location of the primary tumor. Among EO‐CRC, approximately 30% of patients are affected by tumors harboring mutations causing hereditary cancer predisposing syndromes, and 20% have familial CRC. Most notably, the remaining 50% of EO‐CRC patients have neither hereditary syndromes nor familial CRC, thus representing a formidable challenge for research. In this review article we summarize epidemiology, clinical and molecular features, heredity and outcome of treatments of EO‐CRC, and provide considerations for future perspectives. The prevalence of hereditary syndromes, familial syndromes and neither hereditary or familial (‘terra incognita’) syndromes among early‐onset colorectal cancer in young individuals. Figures are derived from studies in the text.