Early-Onset Colorectal Cancer—Updates in Screening and Treatment

Dear Colleagues,

Early-onset colorectal cancer (EOCRC) is increasingly recognized as a significant health concern, characterized by the diagnosis of colorectal cancer (CRC) in individuals under the age of 50. The rising incidence of EOCRC necessitates updates in both screening and treatment strategies to effectively manage and treat this patient population. Lowering the age for initial screening, adopting advanced diagnostic technologies, and utilizing a multidisciplinary treatment approach are critical steps in improving outcomes for younger CRC patients. Ongoing research and adaptations of clinical practices are essential to address the unique challenges posed by EOCRC. We welcome articles on the following subjects:

Screening

Lowering the age for initial screening: Medical guidelines have been updated to recommend starting routine CRC screening at age 45 instead of 50. This change aims to catch the disease earlier in younger populations who are experiencing a rising incidence of CRC.

High-risk populations: For individuals with a family history of CRC, genetic predispositions (such as Lynch syndrome), or other risk factors, earlier and more frequent screening is recommended. Personalized screening plans are crucial for these high-risk groups.

Advanced screening techniques: There is a push for utilizing more advanced and sensitive screening methods. These include high-definition colonoscopy, fecal immunochemical tests (FITs), and multi-target stool DNA tests. These methods improve the detection rates of precancerous lesions and early-stage cancers.

Treatment

Multidisciplinary approach: Treatment of EOCRC often involves a multidisciplinary team, including oncologists, surgeons, radiologists, and genetic counselors, to provide comprehensive care tailored to the younger patient population.

Surgical innovations: Minimally invasive surgical techniques, such as laparoscopic and robotic surgeries, are being increasingly used. These methods reduce recovery time and postoperative complications, which is particularly beneficial for younger patients.

Targeted therapies and immunotherapy: Advances in the molecular profiling of tumors have led to the development of targeted therapies that are more effective and have fewer side effects compared to traditional chemotherapy. Immunotherapies, which harness a patient’s immune system to fight cancer, are also showing promise in treating EOCRC.

Genetic counseling and testing: Given the higher likelihood of genetic mutations in younger CRC patients, genetic counseling and testing are recommended. Identifying genetic mutations can influence treatment decisions and guide screening for family members.

Supportive care: Younger patients with CRC often face unique psychosocial challenges, including impacts on fertility, career, and family life. Comprehensive supportive care, including psychological support, fertility preservation, and rehabilitation services, is essential.

We look forward to your contributions.

Dr. Valentin Calu
Guest Editor

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