Increasing Incidence and Knowledge Gaps Within a Clinical Challenge: Understanding the Paradox and Complexities of Young-Onset Colorectal Cancer

摘要

A disproportionate rise in the incidence of young-onset colorectal cancer has been reported, particularly in high-income countries where these findings contrast with declining rates in older adults. In response to this noted increase in young-onset colorectal cancer rates, the American Cancer Society lowered the screening age to 45 years in normal-risk individuals because the majority of newly diagnosed cases are not associated with pathogenic germline mutations. However, the etiology of nongenetically mediated young-onset colorectal cancer remains elusive and raises the question of what role environmental and societal risk factors have in carcinogenesis, such as sedentary lifestyle, processed food intake, and the potential association with increased rates of pediatric inflammatory bowel disease. The deficiencies in our understanding of the drivers behind these worrisome changes are highlighted in the article by You et al, who outline important clinical factors to consider in the management of young-onset colorectal cancer.