Early-onset colorectal cancer in a developing region: A five-year real-world analysis from Brazil.

e15704 Background: Numerous studies have reported a rising incidence of cancer among young adults worldwide, particularly colorectal cancer (CRC), raising concerns about shifts in epidemiological patterns traditionally associated with older populations. While most data originate from high-income countries, there is a paucity of real-world evidence from middle-income regions, including Brazil. Understanding regional trends in CRC among individuals younger than 50 years is essential to inform prevention strategies, screening policies, and health system planning. Methods: We conducted a retrospective, descriptive, population-based study evaluating all newly diagnosed cases of colorectal cancer between 2020 and 2024 in the southern region of Espírito Santo, Brazil. Data were obtained from institutional cancer registries and medical records. Variables analyzed included year of diagnosis, sex, and age at diagnosis. Early-onset colorectal cancer (EOCRC) was defined as diagnosis before 50 years of age. Absolute numbers and proportions of EOCRC cases were calculated for each year of the study period. Results: Between 2020 and 2024, a total of 708 patients were diagnosed with colorectal cancer. Of these, 128 patients (18.1%) were younger than 50 years at diagnosis. In 2020, 142 cases were identified (61 men, 81 women), with 26 patients (18.3%) under 50 years. In 2021, 155 cases were diagnosed (77 men, 78 women), including 24 patients (15.5%) younger than 50 years. In 2022, 156 cases were recorded (70 men, 86 women), with a notable increase to 41 early-onset cases (26.3%). In 2023, 124 cases were diagnosed (72 men, 52 women), of which 15 patients (12.1%) were under 50 years. In 2024, 131 cases were identified, including 22 patients (16.8%) younger than 50 years. Across the study period, EOCRC represented a consistent and clinically significant proportion of all CRC diagnoses, with a peak observed in 2022. Conclusions: Colorectal cancer in individuals younger than 50 years represents a substantial and persistent burden in the southern region of Espírito Santo, Brazil. The sustained proportion of early-onset cases highlights an urgent need for public health policies specifically targeting colorectal cancer in younger populations, including earlier screening strategies, risk factor modification, and improved awareness among healthcare professionals and the general population. These findings reinforce the importance of adapting national cancer control policies in Brazil to emerging epidemiological trends, aiming to reduce morbidity and mortality associated with early-onset colorectal cancer.