Early-onset Colorectal Cancer

Mo Ah Jeong; Hyoun Woo Kang

doi:10.4166/kjg.2019.74.1.4

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Jeong and Kang: Early-onset Colorectal Cancer

Review Article

The Korean Journal of Gastroenterology 2019; 74(1): 4-10.

Published online: 26 July 2019

DOI: https://doi.org/10.4166/kjg.2019.74.1.4

Early-onset Colorectal Cancer

Mo Ah Jeong, Hyoun Woo Kang

Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.

Correspondence to: Hyoun Woo Kang, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 27 Dongguk-ro, Ilsandong-gu, Goyang 10326, Korea. Tel: +82-31-961-7128, Fax: +82-31-961-9309, gangmali@naver.com

Received 26 June 2019 Revised 20 July 2019 Accepted 21 July 2019

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The incidence of colorectal cancer (CRC) is increasing among young adults in several countries including the United States. Early-onset colorectal cancer (EO-CRC) is heterogenous group and appears to have a distinct clinical, pathologic, and molecular presentation compared to CRC diagnosed in older patients. EO-CRC patients tend to be diagnosed at later stage and with symptomatic disease. Tumors arise predominantly in the distal colon and rectum and have poorer histological features. Microsatellite and chromosome stable molecular pathway is frequently observed in EO-CRC. Survival data of EO-CRC is conflicting and younger patients tend to be treated more aggressively. It is important to identify high risk and have them screened appropriately to address increasing EO-CRC. Screening and treatment strategies for EO-CRC should be developed through further investigation of molecular mechanism and various environmental risk factors. In Korea, EO-CRC and late-onset CRC have both declined in recent several years, probably due to many screening colonoscopies in young population. Close observation and analysis of EO-CRC in Korea is necessary.

Keywords: Colorectal cancer, Young adult, Mass screening, Molecular pathway

Figures and Tables

Fig. 1

Age-adjusted incidence of colorectal cancer among individuals younger and older than 50 years in USA from 1975 to 2016 (surveillance, epidemiology and end results program [SEER program]; https://seer.cancer.gov/statfacts/html/colorect.html) and in Korea from 1999 to 2016 (data from Korean Ministry of Health and Welfare).

Table 1

Characteristics of Early-onset Colorectal Cancer Compared with Late-onset Colorectal Cancer

MSI, microsatellite instability; CIMP, CpG island methylater phenotype; MACS, microsatellite and chromosome stable; LINE, long interspersed nuclear elements.

Notes

^{Financial support} None.

^{Conflict of interest} None.

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ORCID iDs: Hyoun Woo Kang
https://orcid.org/0000-0003-3431-0827
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