Young Patients with Colorectal Cancer: Risk, Screening, and Treatment

Abstract

While the incidence and mortality of colorectal cancer have been declining in the USA in the last decades, there is a considerable increase in the incidence of this malignancy in the young adult patients. Several environmental and genetic factors have been studied and known to be associated with colorectal cancer. However, the exact causes of this increase are not clear. Therefore, in this review, we aimed to provide insights in terms of novel findings and avenues of research that may lead to a better way to treat this population of patients. Obesity and its associated behaviors, such as unhealthy dietary patterns and sedentary lifestyles, as well as gut microbiota may play a crucial role in colorectal cancer (CRC) risk for young adults. Recently, the American Cancer Society recommends that adults aged 45 years and older with an average risk of CRC undergo regular screening with either a high-sensitivity stool-based test or a structural examination, depending on patient preference and test availability. It is important to note that data on outcomes associated with systemic cytotoxic and biologic therapy specifically in young patients with CRC are lacking. In this review, we provide an overview on the most recent evidence regarding incidence, screening, molecular features, and management of young patients with colorectal cancer.