单位：[1]Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland[2]Department of Surgery, Middlemore Hospital, Auckland, New Zealand[3]Department of Surgery, Cantonal Hospital, Winterthur, Switzerland[4]Department of Surgery, Barmherzige Brüder Krankenhaus Graz, Graz, Austria[5]Department of Surgery, Bellvitge University Hospital, Barcelona, Spain[6]Department of Surgery, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Madrid, Spain[7]Department of Surgery, University Hospital Magdeburg, Magdeburg, Germany[8]Department of Colorectal Surgery, AdventHealth, Orlando, Florida[9]Department of Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom[10]Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel[11]Department of Surgery, University Hospital Poitiers, Poitiers, France[12]Department of Surgery, National Cancer Institute, Vilnius, Lithuania[13]Department of Surgery, Wits Donald Gordon Medical Centre, Johannesburg, South Africa[14]Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile[15]Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom[16]Department of Surgery, St-Petersburg Clinical Scientific and Practical Centre, St Petersburg, Russia[17]Department of Surgery, Morriston Hospital, Swansea, Wales, United Kingdom[18]Department of Surgery, UZ Leuven, Leuven, Belgium[19]Department of Surgery, University Hospital Cologne, Cologne, Germany[20]Department of Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa[21]Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands[22]Department of Surgery, St Paul's Hospital, the University of British Columbia, Vancouver, British Columbia, Canada[23]Department of Clinical Pathology, the University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Australia[24]Department of Surgery, Skåne University Hospital, Malmö, Sweden[25]Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands[26]Department of Surgery, Leningrad Regional Clinical Oncology Dispensary, Leningrad, Russia[27]Department of Surgery, Policlinico Tor Vergata, Rome, Italy[28]Department of Surgery, Bordeaux University Hospital, Bordeaux, France[29]Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy[30]Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore, Singapore[31]Department of Surgery, Lugano Regional Hospital, Lugano, Switzerland[32]Department of Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia[33]Department of Surgery, Keck Hospital, University of Southern California, Los Angeles[34]Department of Surgery, Pontificia Universidad Catolica de Chile, Santiago, Chile[35]Department of Surgery, St-Pierre University Hospital, Brussels, Belgium[36]Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge, United Kingdom[37]Colorectal Surgical Oncology, Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G[P]etrov National Medical Research Centre of Oncology, St Petersburg, Russia[38]Department of Surgery, Milton S[H]ershey Medical Center, Hershey, Pennsylvania[39]Department of Surgery, Institute of Cancer of São Paulo, São Paulo, Brazil[40]Department of Surgery, Siberian State Medical University, Tomsk, Russia[41]Department of Surgery, Rambam Health Care Campus, Haifa, Israel[42]Department of Surgery, Western General Hospital, Edinburgh, United Kingdom[43]Department of Surgery, Military Medical Academy University Teaching Hospital, Łódź, Poland[44]Department of Surgery, Sechenov First Moscow State Medical University, Moscow, Russia[45]Department of Surgery, Aalborg University Hospital, Aalborg, Denmark[46]Department of Surgery, Whangarei Hospital, Whangarei, New Zealand[47]Department of Surgery, Mansoura University Hospital, Mansoura, Egypt[48]Colorectal Surgery Unit, General Surgery Service, Hospital Vall de Hebron, Barcelona, Spain[49]Department of Visceral Surgery, University Hospital Lausanne, Lausanne, Switzerland[50]Department of Surgery, St Mark's Hospital, London, United Kingdom[51]Department of Surgery, University of Rochester, New York[52]Department of Surgery, University Hospital La Fe, Valencia, Spain[53]Department of Surgery, Champalimaud Clinical Centre, Lisbon, Portugal[54]Department of Surgery, Tygerberg Academic Hospital, Cape Town, South Africa[55]Department of Surgery, Christchurch Hospital, Christchurch, New Zealand[56]Fourth Coloproctology Department, St Petersburg Oncology Center, St Petersburg, Russia[57]Department of Colorectal Surgery, Clínica Santa María, Santiago, Chile[58]Department of Colorectal Surgery, Hospital Militar de Santiago, Le Reina, Chile[59]Department of Surgery,Tongji Hospital,Wuhan,China华中科技大学同济医学院附属同济医院外科学系外科学系[60]Department of Surgery, Clinical Center of Serbia, Belgrade, Serbia[61]Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia[62]Department of Oncology, Oslo University Hospital, Oslo, Norway[63]Division of Human Genetics, The Ohio State University Comprehensive Cancer Center, Columbus[64]Department of Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan[65]Department of Surgery, Aarhus University Hospital, Aarhus, Denmark[66]Department of Surgery, Manchester Royal Infirmary, Manchester, United Kingdom[67]Department of Surgery, Motol University Hospital, Prague, Czech Republic[68]Department of Surgery, German Cancer Research Center, Heidelberg, Germany[69]Department of Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands[70]Vilnius University, Faculty of Medicine, Vilnius, Lithuania[71]Department of Surgery, Austin Hospital, Melbourne, Australia[72]School of Medicine, University of California Irvine, Irvine[73]Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan[74]Surgical Department of Abdominal Oncology, N[N][P]etrov National Medical Research Centre of Oncology, St Petersburg, Russia[75]Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada[76]Division of Colorectal Surgery, Department of Surgery, University of California at Davis Medical Center, Sacramento[77]Advent Health Colorectal Surgery, Orlando, Florida[78]Department of Surgery, Royal Prince Alfred Hospital, Sydney, Australia[79]Department of Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands[80]University of Glasgow, Glasgow, United Kingdom[81]Department of Surgery, Ziekenhuis Oost-Limburg, Belgium[82]Department of Surgery, Royal Marsden Hospital, London, United Kingdom[83]Department of Surgery, Stavanger University Hospital, Stavanger, Norway[84]Medical University Innsbruck, Innsbruck, Austria[85]Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, Australia[86]School of Medicine, Uludag University, Bursa, Turkey[87]Department of Surgery, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands[88]Department of Surgery, University Hospital Besançon, Besançon, France[89]Department of Surgery, Mayo Clinic, Rochester, Minnesota[90]Department of Surgery, University of Szeged, Szeged, Hungary[91]Kyung Here University Hospital at Gangdong, Seoul, South Korea[92]Sorbonne Université, Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Hôpital St Antoine, Paris, France[93]Department of Surgery, Helsinki University Hospital, Helsinki, Finland[94]Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora[95]Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Australia[96]Department of Surgery, Karolinska University Hospital, Stockholm, Sweden[97]Department of Surgery, University Hospital Erlangen, Erlangen, Germany[98]Department of Surgery, University Hospital Nantes, Nantes, France[99]Department of Surgery, La Fe University Hospital, Valencia, Spain[100]AdventHealth Medical Group Colorectal Surgery, AdventHealth, Orlando, Florida[101]Department for Hereditary Tumors, Evangelisches Krankenhaus Bethesda, Duisburg, Germany[102]Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania[103]Department of Surgery, Pavlov First St Petersburg State Medical University's Clinic, St Petersburg, Russia[104]Department of Surgery, University Hospital Concepción, Concepción, Chile[105]Department of Surgery, Keio University, Tokyo, Japan[106]Department of Surgery, National Cancer Institute, Mexico City, Mexico[107]Department of Surgery, Angelita and Joaquim Gama Institute, São Paulo, Brazil[108]Department of Surgery, Beaujon Hospital, Paris, France[109]Department of Medical Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus[110]Department of Surgery, St Boniface General Hospital, Winnipeg, Manitoba, Canada[111]Department of Gastroenterology, University of Colorado Anschutz Medical Campus, Aurora[112]Colorectal Surgery Department, British Hospital of Buenos Aires, Buenos Aires, Argentina[113]Department of Surgery, Hospital del Mar, Barcelona, Spain[114]Colorectal Surgery Division, Angelita and Joaquim Gama Institute, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil[115]Department of Surgery, Haukeland University Hospital, Bergen, Norway[116]Faculty of Medicine, Vilnius University, Vilnius, Lithuania[117]Department of Surgery, University Hospital Zurich, Zurich, Switzerland[118]Department of Surgery, Centro Hospitalar de Leiria, Leiria, Portugal[119]Department of Surgery, Mannheim University Hospital, Mannheim, Germany[120]Department of Surgery, Colombia National University Hospital, Bogota, Columbia[121]Department of Surgery, University Hospital Geneva, Geneva, Switzerland[122]Department of Surgery, Medical University Vienna, Vienna, Austria[123]Department of Surgery, Hospital Punta Pacífica, Panama City, Panama[124]Glasgow Royal Infirmary, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom[125]Department of Surgery, Tata Memorial Centre, Mumbai, India[126]Department of Surgery, Stockholm South General Hospital, Stockholm, Sweden[127]Department of Surgery, Heidelberg University Hospital, Heidelberg, Germany[128]Department of Biomedical Sciences, Humanitas University, Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy[129]Department of Surgery, Cleveland Clinic, Cleveland, Ohio[130]Department of Surgery, School of Medicine, National University of Singapore, Singapore, Singapore[131]Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, The Netherlands[132]Department of Surgery, Åbenrå Hospital, Åbenrå, Denmark[133]Department of Surgery, Lukas Hospital, Neuss, Germany[134]Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands[135]Department of Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia[136]Department of Surgery, Cleveland Clinic Florida, Weston[137]Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC[138]Department of Surgery, Auckland City Hospital, Auckland, New Zealand[139]Department of Surgery, Creta Inter-Clinic Hospital, Heraklion, Crete, Greece[140]Department of Surgery, MD Anderson Cancer Center, Houston, Texas[141]Department of Surgery, Maciel Hospital, Montevideo, Uruguay
The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer.Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts.The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.
第一作者单位：[1]Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
推荐引用方式(GB/T 7714)：
REACCT Collaborative,Alexandra M Zaborowski,Ahmed Abdile,et al.Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.[J].JAMA SURGERY.2021,156(9):865-874.doi:10.1001/jamasurg.2021.2380.
APA：
REACCT Collaborative,Alexandra M Zaborowski,Ahmed Abdile,Michel Adamina,Felix Aigner...&Des C Winter.(2021).Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review..JAMA SURGERY,156,(9)
MLA：
REACCT Collaborative,et al."Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.".JAMA SURGERY 156..9(2021):865-874
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