LITERATURE UPDATE
All patients with stage II-III rectal cancer who underwent neoadjuvant therapy and curative rectal resection between January 2018 and December 2023 were included and allocated to eoRC (<50 years) and loRC (≥50 years) groups based on their age at diagnosis. A total of 381 patients were included
An opened colectomy specimen containing an invasive colorectal carcinoma and two adenomatous polyps.
patients with EOC than in those with LOC for the following neoplasms: head and neck (6.1% vs. 4.6%), colon (11.0% vs. 8.2%), testicular (16.3% vs. -13.1%), non-Hodgkin lymphoma (8.4% vs. 5.9%), rectum (16.1% vs. 6.8%), kidney (27.8% vs.20.1%), and sarcoma (43.4% vs. 28.6%). This increase was confirmed in patients younger than 45 years and 40 years. These results are consistent with the
data published for most tumour sites analysed. This global public health problem requires the utmost atention to decrease excess cancer in young patients.
Trends in young-onset cancer incidence: a modeling perspective Owens L, Fung A, Shuhendler J et al. J Natl Cancer Inst. 2025 Jul 1;117(7):1350–9. doi: 10.1093/jnci/djaf050.
Recent increases in the diagnosis of certain cancers among younger individuals are generating intense concern. Many studies atribute the increase in the so-called young-onset cancer to an aetiologic cause but questions have also arisen about the role of earlier diagnosis. Here, the authors simulated incidence
trends from a natural history model that includes healthy, preclinical, and clinical disease states, where the transition from the healthy to the preclinical state represents disease onset and the transition from the preclinical to the clinical state represents diagnosis. They superimposed birth-cohort effects on the rate of disease onset and period effects on the rate of disease diagnosis to identify those that match paterns of relative incidence by age group and five-year calendar interval from 2000 to 2019 for six ‘young-onset’ cancers (colon, rectum, female breast, stomach, pancreas and kidney).
Two types of effects are broadly
consistent with the observed increasing incidence trends in younger individuals: (1) a birth-cohort effect on disease onset that begins around 1970 and becomes more pronounced in later birth years, or (2) a period effect consistent with progressive reduction over time in the duration of preclinical disease. An earlier, protective birth-cohort effect is consistent with recent declining trends in incidence in older individuals for colon, rectal and stomach cancers. A disease model provides clues about
the possible drivers of cancer incidence trends, suggests constraints on the paterns of exposures that might be implicated aetiologically, and indicates that the role of diagnostic changes warrants consideration alongside potential aetiologic explanations.
Age Maters: Early-Onset Rectal Cancer Exhibits Higher Rates of Pathological Complete Response: A Retrospective Analysis of the Influence of Young Age on Treatment Success in Stage II-III Rectal Cancer Sileo A, Sassun R, Ng JC et al. Ann Surg Oncol. 2025 Apr;32(4):2302–7. doi: 10.1245/s10434-024-16773-w.
The incidence of rectal cancer has decreased overall, but the incidence of early-onset rectal cancer (eoRC) has increased. Early-onset rectal cancer and late-onset rectal cancer (loRC) differ due to phenotypical, genetic characteristics, and higher stage presentations in eoRC. Thus, eoRC patients undergo more aggressive neoadjuvant treatments. This paper was designed to evaluate the impact of age on the pathological complete response rates in sporadic locally advanced rectal cancer.
(93 eoRC and 288 loRC). Preoperative radiological imaging revealed higher clinical nodal staging in the eoRC group (P=0.002). A higher proportion of eoRC resulted in a pathological complete response compared with loRC (29% vs. 18.8%, P=0.035). The rate of pathological complete response in eoRC and loRC did not differ between patients treated by total neoadjuvant therapy (TNT) and those treated by standard chemoradiotherapy (29.2% vs. 28.6%, P=0.95 in eoRC and 21.7% vs. 25.9%, P=0.097 in loRC). Multivariable analysis resulted in young age of onset (odds ratio [OR] 2.68; 95% confidence interval [CI] 1.11–6.51; P=.029) and KRAS wildtype (OR 3.37; 95% CI 1.25-9.07; P=0.016) as being independent predictors of pathological complete response. Sporadic eoRC and KRAS wildtype
tumours are predictive factors for pathological complete response in stage II–III rectal cancer.
Implications of Artificial Intelligence for Colorectal Cancer in Young Populations Grunhut J, Newland JJ, Brown RF. J Surg Oncol. 2025 Jun;131(7):1368-1372. doi: 10.1002/jso.28036.
A considerable amount of recent research has focused on the role of artificial intelligence (AI) in colorectal cancer (CRC), aiming to improve outcomes in CRC. However, AI for young onset colorectal cancer (yoCRC) – defined as colorectal cancer in patients less than 50 years old – is not nearly as explored, and its role in the prevention, detection, and management of yoCRC remains largely unknown. To address this gap, the authors
performed an integrative review on AI in yoCRC. They conducted a comprehensive literature search of PubMed, Medline (Ovid), and Embase for articles published from 2020 to 2024, adhering to specific inclusion and exclusion criteria. This integrative review involved gathering information from diverse research designs and literature sources. After removing duplicates and applying inclusion criteria, a total of 11 articles were included in the review.
This analysis identified one review
discussing the importance of AI in yoCRC, three articles presenting research studies mentioning applications for yoCRC, and seven comprehensive investigations utilising AI with a specific focus on yoCRC.
February 2026
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