The increasing incidence of young-onset colorectal cancer

A call to action

Dennis J. Ahnen, Sally W. Wade, Whitney F. Jones, Randa Sifri, Jose Mendoza Silveiras, Jasmine Greenamyer, Stephanie Guiffre, Jennifer Axilbund, Andrew Spiegel, Y. Nancy You

Research output: Contribution to journalArticle

Abstract

In the United States, colorectal cancer (CRC) is the third most common and second most lethal cancer. More than one-tenth of CRC cases (11% of colon cancers and 18% of rectal cancers) have a young onset (ie, occurring in individuals younger than 50 years). The CRC incidence and mortality rates are decreasing among all age groups older than 50 years, yet increasing in younger individuals for whom screening use is limited and key symptoms may go unrecognized. Familial syndromes account for approximately 20% of young-onset CRCs, and the remainder are typically microsatellite stable cancers, which are more commonly diploid than similar tumors in older individuals. Young-onset CRCs are more likely to occur in the distal colon or rectum, be poorly differentiated, have mucinous and signet ring features, and present at advanced stages. Yet, stage-specific survival in patients with young-onset CRC is comparable to that of patients with later-onset cancer. Primary care physicians have an important opportunity to identify high-risk young individuals for screening and to promptly evaluate CRC symptoms. Risk modification, targeted screening, and prophylactic surgery may benefit individuals with a predisposing hereditary syndrome or condition (eg, inflammatory bowel disease) or a family history of CRC or advanced adenomatous polyps. When apparently average-risk young adults present with CRC-like symptoms (eg, unexplained persistent rectal bleeding, anemia, and abdominal pain), endoscopic work-ups can expedite diagnosis. Early screening in high-risk individuals and thorough diagnostic work-ups in symptomatic young adults may improve young-onset CRC trends.

Original languageEnglish (US)
Pages (from-to)216-224
Number of pages9
JournalMayo Clinic Proceedings
Volume89
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Colorectal Neoplasms
Incidence
Young Adult
Neoplasms
Adenomatous Polyps
Primary Care Physicians
Rectal Neoplasms
Diploidy
Inflammatory Bowel Diseases
Rectum
Microsatellite Repeats
Colonic Neoplasms
Abdominal Pain
Anemia
Colon
Age Groups
Hemorrhage
Survival
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ahnen, D. J., Wade, S. W., Jones, W. F., Sifri, R., Silveiras, J. M., Greenamyer, J., ... You, Y. N. (2014). The increasing incidence of young-onset colorectal cancer: A call to action. Mayo Clinic Proceedings, 89(2), 216-224. https://doi.org/10.1016/j.mayocp.2013.09.006

The increasing incidence of young-onset colorectal cancer : A call to action. / Ahnen, Dennis J.; Wade, Sally W.; Jones, Whitney F.; Sifri, Randa; Silveiras, Jose Mendoza; Greenamyer, Jasmine; Guiffre, Stephanie; Axilbund, Jennifer; Spiegel, Andrew; You, Y. Nancy.

In: Mayo Clinic Proceedings, Vol. 89, No. 2, 2014, p. 216-224.

Research output: Contribution to journalArticle

Ahnen, DJ, Wade, SW, Jones, WF, Sifri, R, Silveiras, JM, Greenamyer, J, Guiffre, S, Axilbund, J, Spiegel, A & You, YN 2014, 'The increasing incidence of young-onset colorectal cancer: A call to action', Mayo Clinic Proceedings, vol. 89, no. 2, pp. 216-224. https://doi.org/10.1016/j.mayocp.2013.09.006
Ahnen DJ, Wade SW, Jones WF, Sifri R, Silveiras JM, Greenamyer J et al. The increasing incidence of young-onset colorectal cancer: A call to action. Mayo Clinic Proceedings. 2014;89(2):216-224. https://doi.org/10.1016/j.mayocp.2013.09.006
Ahnen, Dennis J. ; Wade, Sally W. ; Jones, Whitney F. ; Sifri, Randa ; Silveiras, Jose Mendoza ; Greenamyer, Jasmine ; Guiffre, Stephanie ; Axilbund, Jennifer ; Spiegel, Andrew ; You, Y. Nancy. / The increasing incidence of young-onset colorectal cancer : A call to action. In: Mayo Clinic Proceedings. 2014 ; Vol. 89, No. 2. pp. 216-224.
@article{b278dd6b2b9e4d6b9d6ee1a89d564861,
title = "The increasing incidence of young-onset colorectal cancer: A call to action",
abstract = "In the United States, colorectal cancer (CRC) is the third most common and second most lethal cancer. More than one-tenth of CRC cases (11{\%} of colon cancers and 18{\%} of rectal cancers) have a young onset (ie, occurring in individuals younger than 50 years). The CRC incidence and mortality rates are decreasing among all age groups older than 50 years, yet increasing in younger individuals for whom screening use is limited and key symptoms may go unrecognized. Familial syndromes account for approximately 20{\%} of young-onset CRCs, and the remainder are typically microsatellite stable cancers, which are more commonly diploid than similar tumors in older individuals. Young-onset CRCs are more likely to occur in the distal colon or rectum, be poorly differentiated, have mucinous and signet ring features, and present at advanced stages. Yet, stage-specific survival in patients with young-onset CRC is comparable to that of patients with later-onset cancer. Primary care physicians have an important opportunity to identify high-risk young individuals for screening and to promptly evaluate CRC symptoms. Risk modification, targeted screening, and prophylactic surgery may benefit individuals with a predisposing hereditary syndrome or condition (eg, inflammatory bowel disease) or a family history of CRC or advanced adenomatous polyps. When apparently average-risk young adults present with CRC-like symptoms (eg, unexplained persistent rectal bleeding, anemia, and abdominal pain), endoscopic work-ups can expedite diagnosis. Early screening in high-risk individuals and thorough diagnostic work-ups in symptomatic young adults may improve young-onset CRC trends.",
author = "Ahnen, {Dennis J.} and Wade, {Sally W.} and Jones, {Whitney F.} and Randa Sifri and Silveiras, {Jose Mendoza} and Jasmine Greenamyer and Stephanie Guiffre and Jennifer Axilbund and Andrew Spiegel and You, {Y. Nancy}",
year = "2014",
doi = "10.1016/j.mayocp.2013.09.006",
language = "English (US)",
volume = "89",
pages = "216--224",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "2",

}

TY - JOUR

T1 - The increasing incidence of young-onset colorectal cancer

T2 - A call to action

AU - Ahnen, Dennis J.

AU - Wade, Sally W.

AU - Jones, Whitney F.

AU - Sifri, Randa

AU - Silveiras, Jose Mendoza

AU - Greenamyer, Jasmine

AU - Guiffre, Stephanie

AU - Axilbund, Jennifer

AU - Spiegel, Andrew

AU - You, Y. Nancy

PY - 2014

Y1 - 2014

N2 - In the United States, colorectal cancer (CRC) is the third most common and second most lethal cancer. More than one-tenth of CRC cases (11% of colon cancers and 18% of rectal cancers) have a young onset (ie, occurring in individuals younger than 50 years). The CRC incidence and mortality rates are decreasing among all age groups older than 50 years, yet increasing in younger individuals for whom screening use is limited and key symptoms may go unrecognized. Familial syndromes account for approximately 20% of young-onset CRCs, and the remainder are typically microsatellite stable cancers, which are more commonly diploid than similar tumors in older individuals. Young-onset CRCs are more likely to occur in the distal colon or rectum, be poorly differentiated, have mucinous and signet ring features, and present at advanced stages. Yet, stage-specific survival in patients with young-onset CRC is comparable to that of patients with later-onset cancer. Primary care physicians have an important opportunity to identify high-risk young individuals for screening and to promptly evaluate CRC symptoms. Risk modification, targeted screening, and prophylactic surgery may benefit individuals with a predisposing hereditary syndrome or condition (eg, inflammatory bowel disease) or a family history of CRC or advanced adenomatous polyps. When apparently average-risk young adults present with CRC-like symptoms (eg, unexplained persistent rectal bleeding, anemia, and abdominal pain), endoscopic work-ups can expedite diagnosis. Early screening in high-risk individuals and thorough diagnostic work-ups in symptomatic young adults may improve young-onset CRC trends.

AB - In the United States, colorectal cancer (CRC) is the third most common and second most lethal cancer. More than one-tenth of CRC cases (11% of colon cancers and 18% of rectal cancers) have a young onset (ie, occurring in individuals younger than 50 years). The CRC incidence and mortality rates are decreasing among all age groups older than 50 years, yet increasing in younger individuals for whom screening use is limited and key symptoms may go unrecognized. Familial syndromes account for approximately 20% of young-onset CRCs, and the remainder are typically microsatellite stable cancers, which are more commonly diploid than similar tumors in older individuals. Young-onset CRCs are more likely to occur in the distal colon or rectum, be poorly differentiated, have mucinous and signet ring features, and present at advanced stages. Yet, stage-specific survival in patients with young-onset CRC is comparable to that of patients with later-onset cancer. Primary care physicians have an important opportunity to identify high-risk young individuals for screening and to promptly evaluate CRC symptoms. Risk modification, targeted screening, and prophylactic surgery may benefit individuals with a predisposing hereditary syndrome or condition (eg, inflammatory bowel disease) or a family history of CRC or advanced adenomatous polyps. When apparently average-risk young adults present with CRC-like symptoms (eg, unexplained persistent rectal bleeding, anemia, and abdominal pain), endoscopic work-ups can expedite diagnosis. Early screening in high-risk individuals and thorough diagnostic work-ups in symptomatic young adults may improve young-onset CRC trends.

UR - http://www.scopus.com/inward/record.url?scp=84897575984&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84897575984&partnerID=8YFLogxK

U2 - 10.1016/j.mayocp.2013.09.006

DO - 10.1016/j.mayocp.2013.09.006

M3 - Article

VL - 89

SP - 216

EP - 224

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 2

ER -