A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers. (18th August 2021)
- Record Type:
- Journal Article
- Title:
- A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers. (18th August 2021)
- Main Title:
- A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers
- Authors:
- Cercek, Andrea
Chatila, Walid K
Yaeger, Rona
Walch, Henry
Fernandes, Gustavo Dos Santos
Krishnan, Asha
Palmaira, Lerie
Maio, Anna
Kemel, Yelena
Srinivasan, Preethi
Bandlamudi, Chaitanya
Salo-Mullen, Erin
Tejada, Prince R
Belanfanti, Kimeisha
Galle, Jesse
Joseph, Vijai
Segal, Neil
Varghese, Anna
Reidy-Lagunes, Diane
Shia, Jinru
Vakiani, Efsevia
Mondaca, Sebastian
Mendelsohn, Robin
Lumish, Melissa A
Steinruecke, Felix
Kemeny, Nancy
Connell, Louise
Ganesh, Karuna
Markowitz, Arnold
Nash, Garrett
Guillem, Jose
Smith, J Joshua
Paty, Phillip B
Zhang, Liying
Mandelker, Diana
Birsoy, Ozge
Robson, Mark
Offit, Kenneth
Taylor, Barry
Berger, Michael
Solit, David
Weiser, Martin
Saltz, Leonard B
Aguilar, Julio Garcia
Schultz, Nikolaus
Diaz, Luis A
Stadler, Zsofia K
… (more) - Abstract:
- Abstract: Background: The causative factors for the recent increase in early-onset colorectal cancer (EO-CRC) incidence are unknown. We sought to determine if early-onset disease is clinically or genomically distinct from average-onset colorectal cancer (AO-CRC). Methods: Clinical, histopathologic, and genomic characteristics of EO-CRC patients (2014-2019), divided into age 35 years and younger and 36-49 years at diagnosis, were compared with AO-CRC (50 years and older). Patients with mismatch repair deficient tumors, CRC-related hereditary syndromes, and inflammatory bowel disease were excluded from all but the germline analysis. All statistical tests were 2-sided. Results: In total, 759 patients with EO-CRC (35 years, n = 151; 36-49 years, n = 608) and AO-CRC (n = 687) were included. Left-sided tumors (35 years and younger = 80.8%; 36-49 years = 83.7%; AO = 63.9%; P < .001 for both comparisons), rectal bleeding (35 years and younger = 41.1%; 36-49 years = 41.0%; AO = 25.9%; P = .001 and P < .001, respectively), and abdominal pain (35 years and younger = 37.1%; 36-49 years = 34.0%; AO = 26.8%; P = .01 and P = .005, respectively) were more common in EO-CRC. Among microsatellite stable tumors, we found no differences in histopathologic tumor characteristics. Initially, differences in TP53 and Receptor Tyrosine Kinase signaling pathway (RTK-RAS)alterations were noted by age. However, on multivariate analysis including somatic gene analysis and tumor sidedness,Abstract: Background: The causative factors for the recent increase in early-onset colorectal cancer (EO-CRC) incidence are unknown. We sought to determine if early-onset disease is clinically or genomically distinct from average-onset colorectal cancer (AO-CRC). Methods: Clinical, histopathologic, and genomic characteristics of EO-CRC patients (2014-2019), divided into age 35 years and younger and 36-49 years at diagnosis, were compared with AO-CRC (50 years and older). Patients with mismatch repair deficient tumors, CRC-related hereditary syndromes, and inflammatory bowel disease were excluded from all but the germline analysis. All statistical tests were 2-sided. Results: In total, 759 patients with EO-CRC (35 years, n = 151; 36-49 years, n = 608) and AO-CRC (n = 687) were included. Left-sided tumors (35 years and younger = 80.8%; 36-49 years = 83.7%; AO = 63.9%; P < .001 for both comparisons), rectal bleeding (35 years and younger = 41.1%; 36-49 years = 41.0%; AO = 25.9%; P = .001 and P < .001, respectively), and abdominal pain (35 years and younger = 37.1%; 36-49 years = 34.0%; AO = 26.8%; P = .01 and P = .005, respectively) were more common in EO-CRC. Among microsatellite stable tumors, we found no differences in histopathologic tumor characteristics. Initially, differences in TP53 and Receptor Tyrosine Kinase signaling pathway (RTK-RAS)alterations were noted by age. However, on multivariate analysis including somatic gene analysis and tumor sidedness, no statistically significant differences at the gene or pathway level were demonstrated. Among advanced microsatellite stable CRCs, chemotherapy response and survival were equivalent by age cohorts. Pathogenic germline variants were identified in 23.3% of patients 35 years and younger vs 14.1% of AO-CRC ( P = .01). Conclusions: EO-CRCs are more commonly left-sided and present with rectal bleeding and abdominal pain but are otherwise clinically and genomically indistinguishable from AO-CRCs. Aggressive treatment regimens based solely on the age at CRC diagnosis are not warranted. … (more)
- Is Part Of:
- Journal of the National Cancer Institute. Volume 113:Number 12(2021)
- Journal:
- Journal of the National Cancer Institute
- Issue:
- Volume 113:Number 12(2021)
- Issue Display:
- Volume 113, Issue 12 (2021)
- Year:
- 2021
- Volume:
- 113
- Issue:
- 12
- Issue Sort Value:
- 2021-0113-0012-0000
- Page Start:
- 1683
- Page End:
- 1692
- Publication Date:
- 2021-08-18
- Subjects:
- Cancer -- Periodicals
Cancer -- Research -- Periodicals
616.994 - Journal URLs:
- https://jnci.oxfordjournals.org/ ↗
http://ukcatalogue.oup.com/ ↗ - DOI:
- 10.1093/jnci/djab124 ↗
- Languages:
- English
- ISSNs:
- 0027-8874
- Deposit Type:
- Legaldeposit
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- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 4830.000000
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