Watch for the Warnings of Early-Onset Colorectal Cancer
Adolescents and young adults (AYAs) aged 20–39 account for the steepest increase (https://doi.org/10.1158/1055-9965.EPI-21-0611) in the rising rates of early-onset colorectal cancer, but identification of early warning signs and vigilant screening can prevent the predictions of the incidence doubling (https://doi.org/10.4251%2Fwjgo.v13.i8.856) by 2030 in patients younger than 50 years. According to the results of a new study (https://doi.org/10.1093/jnci/djad068) published in the Journal of the National Cancer Institute, four red flags should trigger clinicians to refer younger individuals for early detection testing.
For their matched case-control study, researchers analyzed the commercial health insurance service claims of 5,075 patients with early-onset colorectal cancer and 22 ,378 cancer-free controls in the MarketScan Commercial Database. They compared the signs and symptom reported by at least 2% of individuals in both groups and found four key warnings associated with an increased risk for early-onset colorectal cancer:
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Abdominal pain (11.6% of patients)
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Rectal bleeding (7.2%)
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Diarrhea (2.8%)
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Iron-deficiency anemia (2.3%)
Experiencing one of the signs was linked to a twofold likelihood of early-onset colorectal cancer, whereas three or more of the signs increased the likelihood by six times.
AYAs and other younger individuals may sometimes ignore symptoms or attribute them to other conditions, but the researchers found that acting on the four red flags led to the greatest impact on early detection for patients aged 18–44 years.
“Colorectal cancer is no longer a disease of just the older population,” the study’s principal investigator said in a subsequent interview (https://www.cancer.gov/news-events/cancer-currents-blog/2023/colorectal-cancer-young-people-warning-signs). “For younger adults, we really want to raise awareness that if you have any of these signs or symptoms, don’t wait.”
Several biomarkers are linked to hereditary cancer syndromes that may also increase an individual’s risk for developing early-onset colorectal cancer. Search the ONS Biomarker Database (https://biomarkers.ons.org/biomarkers/) to learn more about the genetics and genomics behind the disease, then use the resources in the Colorectal Cancer Learning Library (https://www.ons.org/learning-libraries/colorectal-cancer) in your patient treatment and care.