Rising incidences of young onset colorectal cancer (CRC) poses unique challenges

Colorectal cancer (CRC), traditionally considered a disease of older individuals, is increasingly affecting younger individuals

presenting a shift in the demographic landscape of this malignancy. This young onset CRC now represents a significant cancer burden among younger adults. This disturbing emerging global trend calls for a deeper understanding of the underlying causes, effective prevention, improved diagnostic strategies, and tailored treatment approaches to effectively combat this growing concern.

We know CRC risk factors include consuming red processed meat, excessive alcohol use, obesity, inflammatory bowel disease, CRC family history and predisposing genetic variants of CRC. Some researchers suggest that sedentary lifestyles, high fat diets, obesity and smoking are prevalent among the younger populations increasing their risk for early-onset CRC. Another challenge is the potential genetic component of CRC.

While hereditary CRCs, such as Lynch syndrome and familial adenomatous polyposis, have long been recognized, recent studies have revealed a higher prevalence of genetic mutations in younger patients with CRC.

These genetic aberrations can impact disease progression, treatment response, and the risk of developing secondary cancers in other parts of the body. Therefore, comprehensive genetic testing and counselling are vital in managing young onset CRC, enabling personalized treatment plans and facilitating early detection in at-risk individuals

Screening programs for CRC in many countries continue to adopt the age cut-off of 50 years with some variations in the screening interval. Current guidelines recommend CRC screening at the age of 45 years for a person with average risk for CRC. However, high risk individuals, particularly those with a positive family history of CRC should undergo screening earlier. The optimal screening strategies for this younger age group remain unclear, further complicating early detection efforts. 

The unique challenge posed by the rising incidence of young onset CRC is the delay in early diagnosis and suboptimal management of this disease. Early signs suggestive of CRC are often overlooked or attributed to more common and less concerning conditions. So, a delay in early diagnosis can lead to detection of CRC at a more advanced stage. This not only limits treatment options but also negatively impacts survival rates.

In addition, the psychosocial impact of being diagnosed at a young age cannot be overlooked. It can significantly disrupt an individual’s personal and professional life, leading to emotional distress, financial burden, and challenges in family planning.

Young onset CRC patients need supportive care services that can address their specific needs, including fertility preservation options, psychological support, and survivorship programs. They are invaluable in optimizing the quality of life and long-term outcomes in this population.

Thus, addressing the challenges of young onset CRC requires a multi-prong approach. Public awareness campaigns in addition to increasing awareness among health professionals can help in recognizing early red flag symptoms for early diagnosis and treatment.