TOPLINE:

At a safety-net hospital in Texas, most adults diagnosed with early-onset colorectal cancer (CRC) were Hispanic or Black and presented with advanced-stage disease.

METHODOLOGY:

• Although overall CRC incidence has declined in the United States, cases among adults younger than 50 years are rising by 1.5% per year, and these patients often present with advanced disease and more poorly differentiated histology.
• Researchers conducted a retrospective cohort study to characterize the epidemiologic profile and risk factors in young adults diagnosed with spontaneous CRC in a safety-net hospital system in Texas.
• They included 279 adults younger than 50 years (42.3% women) of non-Hispanic White (9%), Hispanic (67%), or non-Hispanic Black (24%) race with a diagnosis of malignant neoplasm of the colon or rectum between September 2010 and September 2020. Patients with inflammatory bowel disease or clinically suspected or genetically confirmed familial cancer syndromes were excluded.
• Data collection included demographics, age at diagnosis, time to diagnosis, and cancer stage at diagnosis.
• Advanced-stage CRC was defined as stage III or IV disease.

TAKEAWAY:

• Most patients (61.3%) initially presented to the emergency department rather than outpatient settings.
• Advanced-stage CRC was present at diagnosis in 85.7% of patients, despite 67.7% being diagnosed within 3 months of symptom onset.
• Patients aged 40-44 years were over three times more likely to present with advanced disease than those younger than 30 years (odds ratio, 3.11).
• Compared with non-Hispanic White patients, non-Hispanic Black and Hispanic patients had higher odds of presenting with advanced-stage disease, although differences were not statistically significant.

IN PRACTICE:

"Given the findings in this study, a lower threshold of suspicion and system-wide quality improvement interventions may be needed to evaluate patients with possible [early-onset CRC]," the authors wrote.

SOURCE:

The study, led by Vinh Tran, MD, Department of Internal Medicine, Baylor College of Medicine in Houston, was published online in the Journal of Clinical Gastroenterology.

LIMITATIONS: 

The study was limited by the underrepresentation of non-Hispanic White patients as a reference group. Additionally, because the research was conducted in a single safety-net hospital system, findings may not be generalizable to the broader early-onset CRC population or other safety-net hospital systems. Patients who were diagnosed before age 50 but were 50 or older at the time of analysis were excluded.

DISCLOSURES:

This study was supported by the Cancer Prevention and Research Institute of Texas. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.