Colorectal cancer in adolescents and young adults: Defining a growing threat

Pediatr Blood Cancer. 2019 Nov;66(11):e27941. doi: 10.1002/pbc.27941. Epub 2019 Jul 26.

Abstract

Colorectal cancer (CRC) incidence is rising among adolescents and young adults (AYAs), with the greatest increase occurring in distal colon and rectal cancers. Reasons for this striking trend are not well understood. Genetically linked cases of CRC occur in the context of familial conditions such as Lynch Syndrome, but most AYA cases of CRC are sporadic. Unique biology is suggested, yet limited information is available regarding the molecular underpinnings of CRC in this age group. Young patients are more likely to experience delays in diagnosis and to present with advanced-stage disease; yet, prognosis by stage is comparable between younger and older adults. Treatment paradigms are based on evidence reflecting the older adult population. Given the concerning rise in CRC rates among AYAs, there is urgent need for further research into the role of screening from a younger age, biology of disease, and optimal therapies in this age group.

Keywords: adolescents; colorectal neoplasm; young adults.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / genetics
  • Adolescent
  • Adult
  • Age of Onset
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / genetics
  • Delayed Diagnosis
  • Female
  • Fertility Preservation
  • Germ-Line Mutation
  • Humans
  • Incidence
  • Male
  • Morbidity / trends
  • Neoplastic Syndromes, Hereditary / epidemiology
  • Neoplastic Syndromes, Hereditary / genetics
  • Pregnancy
  • Pregnancy Complications, Neoplastic / epidemiology
  • Prognosis
  • Risk Factors
  • SEER Program
  • United States / epidemiology
  • Young Adult