The Increasing Incidence of Young-Onset Colorectal Cancer: A Call to Action

被引:356
作者
Ahnen, Dennis J. [1 ,2 ]
Wade, Sally W. [3 ]
Jones, Whitney F. [4 ,5 ]
Sifri, Randa [6 ]
Silveiras, Jose Mendoza [7 ]
Greenamyer, Jasmine [7 ]
Guiffre, Stephanie [7 ]
Axilbund, Jennifer [8 ]
Spiegel, Andrew [9 ]
You, Y. Nancy [10 ]
机构
[1] Univ Colorado, Sch Med, Dept Vet Affairs, Eastern Colorado Healthcare Syst, Denver, CO USA
[2] Univ Colorado, Sch Med, Div Gastroenterol, Denver, CO USA
[3] Wade Outcomes Res & Consulting, Salt Lake City, UT USA
[4] Univ Louisville, Sch Med, Louisville, KY 40292 USA
[5] Colon Canc Prevent Project, Louisville, KY USA
[6] Thomas Jefferson Univ, Dept Family & Community Med, Philadelphia, PA 19107 USA
[7] Colon Canc Alliance, Washington, DC USA
[8] Johns Hopkins Univ Hosp, Clin Canc Genet & Prevent, Baltimore, MD 21287 USA
[9] Global Colon Canc Alliance, Bala Cynwyd, PA USA
[10] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA
关键词
MSH2 MUTATION CARRIERS; SOCIETY-TASK-FORCE; COLON-CANCER; AMERICAN-COLLEGE; LYNCH-SYNDROME; SCREENING RECOMMENDATIONS; CLINICAL GUIDELINES; PHYSICAL-ACTIVITY; US ADULTS; SURVEILLANCE;
D O I
10.1016/j.mayocp.2013.09.006
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In the United States, colorectal cancer (CRC) is the third most common and second most lethal cancer. More than one-tenth of CRC cases (11% of colon cancers and 18% of rectal cancers) have a young onset (ie, occurring in individuals younger than 50 years). The CRC incidence and mortality rates are decreasing among all age groups older than 50 years, yet increasing in younger individuals for whom screening use is limited and key symptoms may go unrecognized. Familial syndromes account for approximately 20% of young-onset CRCs, and the remainder are typically microsatellite stable cancers, which are more commonly diploid than similar tumors in older individuals. Young-onset CRCs are more likely to occur in the distal colon or rectum, be poorly differentiated, have mucinous and signet ring features, and present at advanced stages. Yet, stage-specific survival in patients with young-onset CRC is comparable to that of patients with later-onset cancer. Primary care physicians have an important opportunity to identify high-risk young individuals for screening and to promptly evaluate CRC symptoms. Risk modification, targeted screening, and prophylactic surgery may benefit individuals with a predisposing hereditary syndrome or condition (eg, inflammatory bowel disease) or a family history of CRC or advanced adenomatous polyps. When apparently average-risk young adults present with CRC-like symptoms (eg, unexplained persistent rectal bleeding, anemia, and abdominal pain), endoscopic work-ups can expedite diagnosis. Early screening in high-risk individuals and thorough diagnostic work-ups in symptomatic young adults may improve young-onset CRC trends. (C) 2014 Mayo Foundation for Medical Education and Research
引用
收藏
页码:216 / 224
页数:9
相关论文
共 65 条
  • [51] Cancer Statistics, 2012
    Siegel, Rebecca
    Naishadham, Deepa
    Jemal, Ahmedin
    [J]. CA-A CANCER JOURNAL FOR CLINICIANS, 2012, 62 (01) : 10 - 29
  • [52] Increase in Incidence of Colorectal Cancer Among Young Men and Women in the United States
    Siegel, Rebecca L.
    Jemal, Ahmedin
    Ward, Elizabeth M.
    [J]. CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 2009, 18 (06) : 1695 - 1698
  • [53] Revised Bethesda Guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability
    Umar, A
    Boland, CR
    Terdiman, JP
    Syngal, S
    de la Chapelle, A
    Rüschoff, J
    Fishel, R
    Lindor, NM
    Burgart, LJ
    Hamelin, R
    Hamilton, SR
    Hiatt, RA
    Jass, J
    Lindblom, A
    Lynch, HT
    Peltomaki, P
    Ramsey, SD
    Rodriguez-Bigas, MA
    Vasen, HFA
    Hawk, ET
    Barrett, JC
    Freedman, AN
    Srivastava, S
    [J]. JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2004, 96 (04) : 261 - 268
  • [54] US Department of Health and Human Services, SURGEON GENERALS FAM
  • [55] US Preventive Services Task Force, SCREENING FOR COLORE
  • [56] US Preventive Services Task Force, 1995, GUIDE TO CLINICAL PR
  • [57] Varma J R, 1990, J Am Board Fam Pract, V3, P54
  • [58] THE INTERNATIONAL-COLLABORATIVE-GROUP-ON-HEREDITARY-NON-POLYPOSIS-COLORECTAL-CANCER (ICG-HNPCC)
    VASEN, HFA
    MECKLIN, JP
    KHAN, PM
    LYNCH, HT
    [J]. DISEASES OF THE COLON & RECTUM, 1991, 34 (05) : 424 - 425
  • [59] Colorectal cancer screening and surveillance: Clinical guidelines and rationale - Update based on new evidence
    Winawer, S
    Fletcher, R
    Rex, D
    Bond, J
    Burt, R
    Ferrucci, J
    Ganiats, T
    Levin, T
    Woolf, S
    Johnson, D
    Kirk, L
    Litin, S
    Simmang, C
    [J]. GASTROENTEROLOGY, 2003, 124 (02) : 544 - 560
  • [60] Colorectal cancer screening: Clinical guidelines and rationale
    Winawer, SJ
    Fletcher, RH
    Miller, L
    Godlee, F
    Stolar, MH
    Mulrow, CD
    Woolf, SH
    Glick, SN
    Ganiats, TG
    Bond, JH
    Rosen, L
    Zapka, JG
    Olsen, SJ
    Giardiello, FM
    Sisk, JE
    vanAntwerp, R
    BrownDavis, C
    Marciniak, DA
    Mayer, RJ
    [J]. GASTROENTEROLOGY, 1997, 112 (02) : 594 - 642