Worrisome Trends in Young-Onset Colorectal Cancer: Now Is the Time for Action

3587 Background: Colorectal cancer is the third-most commonly diagnosed cancer and the second-leading cause of cancer death in men and women combined in the United States. Young-onset colorectal cancer refers to individuals diagnosed under the age of 50. In recent years, the incidence has increased by 2.2% annually in individuals younger than 50 years and 1% in individuals 50-64, in contrast to a 3.3% decrease in adults 65 years and older. Young-onset (YO) CRC patients and survivors face unique clinical challenges with fertility and sexual dysfunctions, but this risk is not well quantified. There is limited data and public discussion on the long-term effects of colorectal cancer treatments on fertility and sexual dysfunction and the long-term impact on the quality of life. Methods: To explore the unique challenges and unmet needs of the young-adult patient population, a cross-sectional study was conducted. Colorectal cancer patients and survivors (N = 884) diagnosed between the ages of 20 to 50 years old (median age 42 ± 7.0) completed an online questionnaire based on established instruments EORTC-QOL-30, EORTC-CR-29, and EORTC-SHC-22. Results: Thirty-one percent of respondents stated that a medical professional spoke to them about fertility preservation at the time of diagnosis and during treatment. Only 31% were referred to a reproductive endocrinologist, even though 37% of women and 16% of men reported that treatment left them infertile or sterile. Among survey respondents, 12% of women had an egg retrieval procedure, and 36% of men had their sperm preserved prior to the start of treatment. Fifty-three percent of women reported treatment led to premature menopause. Sixty-five percent of respondents suffer from some level of sexual dysfunction due to treatment. In patients who received radiation therapy, women were 12% less likely than men to have discussed sexual side effects with the provider before treatment. Patients who have an ostomy reported more severe sexual dysfunction (17.8%). Rectal cancer patients were 2.5 times more likely than those with colon cancer to report severe dysfunction after their treatment. More than 25% of the respondents said they would have considered alternative treatment if they would have known the risks of sexual dysfunction. Conclusions: Our survey demonstrates inadequate communications between patients and providers about the irreversible fertility and sexual effects of colorectal cancer treatments. Younger patients and survivors face unique long-term challenges and require further information about fertility preservation options and emotional support regarding their sexuality post-treatment. Other studies are needed to assess the physical and psychological side effects endured by young-onset CRC patients and survivors.

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Tu1012 – Low Rates of Metachronous Advanced Neoplasia in Individuals with Young-Onset Colorectal Cancer

Gastroenterology ◽

10.1016/s0016-5085(19)39325-4 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-946-S-947

Author(s):

Frank W. Chen ◽

Liu Yang ◽

Vivy Tran ◽

Michelle C. Chong ◽

Jonathan K. Lin ◽

...

Keyword(s):

Colorectal Cancer ◽

Young Onset ◽

Advanced Neoplasia

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Sa1147 GENETIC COMPARISON OF YOUNG-ONSET AND LATE-ONSET COLORECTAL CANCER AND THE DIFFERENCES IN CHINESE AND WESTERN POPULATIONS

Gastroenterology ◽

10.1016/s0016-5085(20)31420-7 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-290-S-291

Author(s):

Xu-xia He ◽

Siyi Yuan ◽

Jing-Nan Li

Keyword(s):

Colorectal Cancer ◽

Late Onset ◽

Young Onset ◽

Genetic Comparison

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Tu1218 RELATIONSHIP BETWEEN GERMLINE MUTATION, PHENOTYPE AND FAMILY HISTORY IN YOUNG ONSET COLORECTAL CANCER

Gastroenterology ◽

10.1016/s0016-5085(20)33229-7 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-1023

Author(s):

Joanne P. Young ◽

Mehgan E. Horsnell ◽

Wendy Uylaki ◽

Reger R. Mikaeel ◽

Amanda Townsend ◽

...

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Germline Mutation ◽

Young Onset

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Sedentary Behaviors, TV Viewing Time, and Risk of Young-Onset Colorectal Cancer

JNCI Cancer Spectrum ◽

10.1093/jncics/pky073 ◽

2018 ◽

Vol 2 (4) ◽

Cited By ~ 18

Author(s):

Long H Nguyen ◽

Po-Hong Liu ◽

Xiaobin Zheng ◽

NaNa Keum ◽

Xiaoyu Zong ◽

...

Keyword(s):

Colorectal Cancer ◽

Proportional Hazards ◽

Statistical Tests ◽

Cox Proportional Hazards ◽

Health Study ◽

Viewing Time ◽

Sedentary Behaviors ◽

Tv Viewing ◽

Young Onset ◽

Increased Risk

Abstract Background Colorectal cancer (CRC) diagnosed before age 50 years, or young-onset CRC, is increasing globally with undefined etiology. A sedentary lifestyle is an emerging risk factor for CRC after age 50 years, but its role in young-onset CRC is unknown. Methods We prospectively evaluated sedentary behaviors, primarily time watching television (TV), and risk of young-onset CRC among 89 278 women in the Nurses’ Health Study II ages 25–42 years at recruitment (1991–2011). We used Cox proportional hazards modelling to estimate relative risks (RR) and 95% confidence intervals (CIs). Statistical tests were two-sided. Results We documented 118 young-onset CRCs over 1 262 540 person-years. Sedentary TV viewing time was statistically significantly associated with increased risk of young-onset CRC, after adjusting for putative risk factors, including obesity and physical activity. Compared to no more than 7 hours per week, women with 7.1–14 hours per week of TV time had a multivariable relative risk (RR) of 1.12 (95% confidence interval [CI] = 0.72 to 1.75), further increased for greater than 14 hours per week (RR = 1.69, 95% CI = 1.07 to 2.67, Ptrend = .03). This association was observed among participants without a CRC family history and was more pronounced for rectal cancer (RR for >14 vs ≤7 hours per week 2.44, 95% CI = 1.03 to 5.78, Ptrend = .04). Overweight or obese participants may be more susceptible. Conclusion Independent of exercise and obesity, prolonged sedentary TV viewing time, a surrogate for a more inactive lifestyle, was associated with increased risk of young-onset CRC, particularly of the rectum. These findings provide further evidence on the importance of maintaining an active lifestyle.

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