Risk factors, histopathological landscape, biomarkers, treatment patterns and survival of early‐onset colorectal cancer: A narrative review

Author:

Garrett Celine123ORCID,Steffens Daniel12,Ackland Stephen4ORCID,Solomon Michael12,Koh Cherry12

Affiliation:

1. Surgical Outcomes Research Centre Royal Prince Alfred Hospital Camperdown Australia

2. Faculty of Medicine & Health Central Clinical School The University of Sydney Camperdown Australia

3. Faculty of Medicine & Health St George and Sutherland Clinical School University of New South Wales Sydney Australia

4. Faculty of Health University of Newcastle Callaghan Australia

Abstract

AbstractEarly‐onset colorectal cancer (EOCRC) incidence has increased in most Western countries over the last decade, with Australia at the forefront. Recent literature has thus focused on characterizing EOCRC from later‐onset colorectal cancer (LOCRC). Earlier exposure to modifiable risk factors resulting in gut dysbiosis has been linked with EOCRC development. EOCRCs have more aggressive histopathological features with somatic mutations resulting in pro‐inflammatory tumor microenvironments. There is a tendency to treat EOCRCs with multimodal chemotherapeutic regimens and more extensive surgery than LOCRCs with conflicting postoperative outcomes and survival data. Current research is limited by a lack of Australasian studies, retrospective study designs, and heterogeneous definitions of EOCRC. Future research should address these and focus on investigating the role of immunotherapies, establishing minimally invasive diagnostic biomarkers and nomograms, and evaluating the survival and functional outcomes of EOCRC.

Publisher

Wiley

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