Colorectal cancer in young adults: A difficult challenge

Sporadic colorectal cancer (CRC) is traditionally diagnosed after the sixth decade of life, and current recommendations for surveillance include only patients older than 50 years of age. However, an increasing incidence of CRC in patients less than 40 years of age has been reported. This occurrence has been attributed to different molecular features and low suspicion of CRC in young symptomatic individuals. When confronting young-onset CRC with older patients, issues such as biological aggressiveness, stage at diagnosis and clinical outcomes seem to differ in many aspects. In the future, the identification of the molecular profile underlying the early development of sporadic CRC will help to plan tailored screening recommendations and improve management. Besides that, differential diagnosis with CRC linked with hereditary syndromes is necessary to provide adequate patient treatment and family screening. Until we find the answers to some of these doubts, doctors should raise suspicion when evaluating an young adult and be aware of this risk and consequences of a late diagnosis.