Colorectal Cancer

Colorectal cancer (CRC) is on the rise in young adults.

CRC (YO-CRC) is defined as colorectal cancer diagnosed in those under the age of 50. Countries such as Australia have one of the highest incidence rates of YO-CRC. By 2030, YO-CRC is expected to account for up to 25% of all rectal cancers and is estimated to be the leading cause of cancer mortality in those under 50 years of age. Genetic studies show very little difference in genetic drivers in YO-CRC compared to older people with CRCs.

Environmental drivers for YO-CRC include the usual suspects such as:

• obesity

• diet

• and physical inactivity.

More recent data suggests that the development of YO-CRC may be due to complex interactions between the microbiome and exposure to environmental factors.

Currently, no one really knows what is driving the rise in YO-CRC.

What we know about patients with YO-CRC

• they are more likely to present with left-sided cancers

• YO CRC patients are more likely to present at an advanced stage.

• up to 30% of patients with YO-CRC have a strong family history

This is arguably because CRC is not a strong differential in young patients who present with rectal bleeding.

This highlights the importance of a good patient history, and staying vigilant. If a young patient has ongoing bowel symptoms after a short period of conservative treatment, a timely referral to a specialist such as a colorectal surgeon may be prudent.