What question did this study set out to answer?

To review the rising global incidence, biological characteristics, risk factors, and unique clinical challenges of young-onset colorectal cancer.

Young Onset Colorectal Cancer

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Narrative review reveals rising incidence and distinct biology of young-onset colorectal cancer, highlighting the need for risk-adapted screening.

To review the rising global incidence, biological characteristics, risk factors, and unique clinical challenges of young-onset colorectal cancer.
Synthesized global and regional epidemiological data evaluating colorectal cancer trends in patients younger than 50 years of age.
Reviewed molecular, genomic, lifestyle, and gut microbiome alterations associated with early-onset disease compared with late-onset cases.
Assessed health economics, survivorship burdens, and clinical management patterns across younger patient cohorts.
The global standardized incidence of young-onset colorectal cancer increased from 3.05 per 100,000 in 1990 to 3.85 per 100,000 in 2019, predominantly featuring left-sided, signet-ring, and advanced-stage tumors.
Pathogenic germline variants are present in approximately 20% of young-onset cases, with Lynch syndrome identified in 8.4% to 13.9% of tested cohorts.
Younger patients are significantly more likely to receive multi-agent adjuvant chemotherapy in early disease stages (p < 0.001 for stage II), yet this aggressive management provides no associated survival benefit.

Aggarwal et al. (2024) studied this question.

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Narrative review reveals rising incidence and distinct biology of young-onset colorectal cancer, highlighting the need for risk-adapted screening.