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PLoS One. 2019 May 16;14(5):e0216472. doi: 10.1371/journal.pone.0216472. eCollection 2019.

Intermediate-onset colorectal cancer: A clinical and familial boundary between both early and late-onset colorectal cancer.

Author information

1
Department of Clinical Biochemistry, "Gregorio Marañón" University Hospital, Madrid, Spain.
2
Department of Surgery, "12 de Octubre" University Hospital, Madrid, Spain.
3
Molecular Biology Laboratory, "12 de Octubre" University Hospital, Madrid, Spain.
4
Centre for Biomedical Research of "12 de Octubre" University Hospital, Madrid, Spain.
5
Department of Pathology, "12 de Octubre" University Hospital, Madrid, Spain.
6
Department of Surgery, "Fundación Jiménez Díaz" University Hospital, Madrid, Spain.
7
Health Research Institute, "Fundación Jiménez Díaz" University Hospital, Madrid, Spain.
8
Molecular Medicine Unit, Department of Medicine, Institute of Molecular and Cellular Biology of Cancer (IBMCC) and Biomedical Research Institute of Salamanca (IBSAL), University of Salamanca-SACYL-CSIC, Salamanca, Spain.
9
Center for Gastrointestinal Research, Center for Translational Genomics and Oncology, Baylor Scott & White Research Institute, Charles A, Sammons Cancer Center, Baylor University Medical Center, Dallas, Texas, United States of America.
10
Centre for Biomedical Network Research on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain.
11
Familial Cancer Clinical Unit, Spanish National Cancer Centre (CNIO), Madrid, Spain.

Abstract

Comparative studies of colorectal cancer (CRC) according to the age of onset have found differences between early-onset CRC (EOCRC) and late-onset CRC (LOCRC). Using this as a starting point, we wished to determine whether intermediate-onset CRC (IOCRC) might also be considered as an independent group within CRC. We performed a retrospective comparative study of the clinicopathological and familial features, as well as of the symptoms and their duration, of a total of 272 subjects diagnosed with CRC classified into three groups according to the age-of-onset (98 EOCRC, 83 IOCRC and 91 LOCRC). The results show that from a clinicopathological point of view, IOCRC shared certain features with EOCRC (gender, prognosis), and with LOCRC (multiple primary CRCs), whereas it also had characteristics that were specific for IOCRC (mean number of associated polyps). A gradual progression was observed from EOCRC to LOCRC from a greater family aggregation to sporadic cases, in parallel with a change of Lynch Syndrome cases to the sporadic microsatellite instability pathway, with the IOCRC being a boundary group that is more related to EOCRC. With respect to symptoms, duration and correlation with stages, IOCRC appeared more similar to EOCRC. Clinically, IOCRC behaves as a transitional group between EOCRC and LOCRC, with features in common with both groups, but also with IOCRC-specific features. Excluding cases with familial cancer history, the awareness for EOCRC diagnosis should be extended to IOCRC.

Conflict of interest statement

The authors have declared that no competing interests exist.

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