scholarly journals Colorectal cancer in adolescents and young adults with Lynch syndrome: a Danish register-based study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053538
Author(s):  
Jon Ambæk Durhuus ◽  
Christina Therkildsen ◽  
Thomas Kallemose ◽  
Mef Nilbert
Keyword(s):  
Colorectal Cancer ◽  
Young Adults ◽  
Lynch Syndrome ◽  
Early Onset ◽  
Early Stage ◽  
Young Patients ◽  
Stage Distribution ◽  
Confounding Variables ◽  
Symptom Awareness ◽  
Cox Analysis

ObjectiveTo assess clinicopathological predictors and prognosis in early-onset colorectal cancer (CRC) in Lynch syndrome with comparison to patients diagnosed from age 40 and up.DesignNational, retrospective register-based case–control study.SettingDanish national hereditary CRC register.ParticipantsIndividuals with Lynch syndrome diagnosed with CRC from January 1950 to June 2020. The analysis was based on 215 early-onset CRCs diagnosed between 15 and 39 years of age and 574 CRCs diagnosed at age 40–88 years.Main outcome measuresClinical and histopathological characteristics and survival. Confounding variables were analysed by Cox analysis.Results27.2% of the tumours in the Danish Lynch syndrome cohort were diagnosed under age 40. Disease-predisposing alterations in MLH1 and MSH2 were overrepresented in the age 15–39 cohort compared with patients diagnosed over age 40. CRCs diagnosed under age 40 showed an adverse stage distribution with 36.2% stage III–IV tumours compared with 25.8% in the over age 40 group. However, young patients diagnosed with early-stage tumours did have a significantly better prognosis compared with early-stage tumours in the older age group.ConclusionsEarly-onset CRC in Lynch syndrome is primarily linked to alterations in MLH1 and MSH2 and displays an adverse stage distribution. These observations serve as a reminder of surveillance, symptom awareness and rapid diagnostic handling of CRC in young adults with Lynch syndrome.

scholarly journals Early-Onset Osteoporosis

2021 ◽  
Author(s):  
Outi Mäkitie ◽  
M. Carola Zillikens
Keyword(s):  
Young Adults ◽  
Early Onset ◽  
Type I Collagen ◽  
Young Patients ◽  
Fragility Fractures ◽  
Underlying Disease ◽  
Bone Fragility ◽  
Sphingolipid Metabolism ◽  
Type I ◽  
Loss Of Function

AbstractOsteoporosis is a skeletal disorder with enhanced bone fragility, usually affecting the elderly. It is very rare in children and young adults and the definition is not only based on a low BMD (a Z-score < − 2.0 in growing children and a Z-score ≤ − 2.0 or a T-score ≤ − 2.5 in young adults) but also on the occurrence of fragility fractures and/or the existence of underlying chronic diseases or secondary factors such as use of glucocorticoids. In the absence of a known chronic disease, fragility fractures and low BMD should prompt extensive screening for secondary causes, which can be found in up to 90% of cases. When fragility fractures occur in childhood or young adulthood without an evident secondary cause, investigations should explore the possibility of an underlying monogenetic bone disease, where bone fragility is caused by a single variant in a gene that has a major role in the skeleton. Several monogenic forms relate to type I collagen, but other forms also exist. Loss-of-function variants in LRP5 and WNT1 may lead to early-onset osteoporosis. The X-chromosomal osteoporosis caused by PLS3 gene mutations affects especially males. Another recently discovered form relates to disturbed sphingolipid metabolism due to SGMS2 mutations, underscoring the complexity of molecular pathology in monogenic early-onset osteoporosis. Management of young patients consists of treatment of secondary factors, optimizing lifestyle factors including calcium and vitamin D and physical exercise. Treatment with bone-active medication should be discussed on a personalized basis, considering the severity of osteoporosis and underlying disease versus the absence of evidence on anti-fracture efficacy and potential harmful effects in pregnancy.

Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323450
Author(s):  
Jinhee Hur ◽  
Ebunoluwa Otegbeye ◽  
Hee-Kyung Joh ◽  
Katharina Nimptsch ◽  
Kimmie Ng ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Young Adults ◽  
Early Onset ◽  
Cox Proportional Hazards ◽  
Adolescents And Young Adults ◽  
Health Study ◽  
Birth Cohorts ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverage ◽  
Early Onset Colorectal Cancer

ObjectiveSugar-sweetened beverage (SSB) consumption had substantially increased across successive US birth cohorts until 2000, and adolescents and young adults under age 50 years have the highest consumption. However, the link between SSBs and early-onset colorectal cancer (EO-CRC) remains unexamined.DesignIn the Nurses’ Health Study II (1991–2015), we prospectively investigated the association of SSB intake in adulthood and adolescence with EO-CRC risk among 95 464 women who had reported adulthood beverage intake using validated food frequency questionnaires (FFQs) every 4 years. A subset of 41 272 participants reported beverage intake at age 13–18 years using a validated high school-FFQ in 1998. Cox proportional hazards models were used to estimate relative risks (RRs) with 95% CIs.ResultsWe documented 109 EO-CRC cases. Compared with individuals who consumed <1 serving/week of SSBs in adulthood, women who consumed ≥2 servings/day had a more than doubled risk of EO-CRC (RR 2.18; 95% CI 1.10 to 4.35; ptrend=0.02), with a 16% higher risk (RR 1.16; 95% CI 1.00 to 1.36) per serving/day increase. Each serving/day increment of SSB intake at age 13–18 years was associated with a 32% higher risk of EO-CRC (RR 1.32; 95% CI 1.00 to 1.75). Replacing each serving/day of adulthood SSB intake with that of artificially sweetened beverages, coffee, reduced fat milk or total milk was associated with a 17%–36% lower risk of EO-CRC.ConclusionHigher SSB intake in adulthood and adolescence was associated with a higher risk of EO-CRC among women. Reduction of SSB consumption among adolescents and young adults may serve as a potential strategy to alleviate the growing burden of EO-CRC.

Molecular screening for lynch syndrome in patients with family history or early-onset colorectal cancer

2006 ◽  
Vol 38 ◽  
pp. S20-S21
Author(s):  
V. Stigliano ◽  
L. Sanchez Mete ◽  
M. Diodoro ◽  
M. Mottolese ◽  
V. Casale
Keyword(s):  
Colorectal Cancer ◽  
Family History ◽  
Lynch Syndrome ◽  
Early Onset ◽  
Molecular Screening ◽  
Early Onset Colorectal Cancer

DNA repair gene polymorphisms and risk of early onset colorectal cancer in Lynch syndrome

2012 ◽  
Vol 36 (2) ◽  
pp. 183-189 ◽  
Author(s):  
Stuart G. Reeves ◽  
Cliff Meldrum ◽  
Claire Groombridge ◽  
Allan Spigelman ◽  
Janina Suchy ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Dna Repair ◽  
Lynch Syndrome ◽  
Early Onset ◽  
Gene Polymorphisms ◽  
Repair Gene ◽  
Dna Repair Gene ◽  
Early Onset Colorectal Cancer

scholarly journals Social Determinants Associated with the Rising Incidence of Early-Onset Colorectal Cancer in the U.S.: A PRISMA Systematic Review

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 302-302
Author(s):  
Laura Amweg ◽  
Laura Hayman
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
United States ◽  
Young Adults ◽  
Early Onset ◽  
The United States ◽  
Literature Study ◽  
Funding Sources ◽  
Prospective Longitudinal ◽  
Early Onset Colorectal Cancer

Abstract Objectives To examine the behavioral, socioeconomic, clinical and systemic characteristics of colorectal cancer (CRC) in young adults (19–49 years of age) in the United States (U.S). Methods A systematic literature review was performed using PRISMA methodology. Eleven electronic databases were searched for the extant literature. Study eligibility criteria included colorectal cancer patients in the United States aged 19–49 years. Articles published in peer-reviewed journals in English between January 2009-April 2019 were included. Results Diet, smoking, low physical activity, and gut microbiome changes were identified as modifiable risk factors associated with early-onset colorectal cancer (EOCRC). Racial disparities existed where African American and Hispanic populations had a higher incidence of EOCRC compared to non-Hispanic Whites. Results suggested that delays in EOCRC diagnosis were caused by delays between symptom presentation and appropriate screening. Limitations included use of non-longitudinal cross-sectional analysis, which cannot explain etiologic causes. Conclusions Public health efforts are needed for better adherence to a healthy dietary pattern and increasing physical activity, to bring awareness to young adults and clinicians alike to know the symptoms of EOCRC, and for young people to get screened early in an ethnically-inclusive manner to reduce disparities. Findings suggest more prospective, longitudinal studies need to be conducted and analyzed to study the etiologic factors of EOCRC. Funding Sources The authors have no funding sources to report.

scholarly journals Erratum to: Evaluating Lynch syndrome in very early onset colorectal cancer probands without apparent polyposis

2013 ◽  
Vol 12 (3) ◽  
pp. 583-583
Author(s):  
Kory W. Jasperson ◽  
Thuy M. Vu ◽  
Angela L. Schwab ◽  
Deborah W. Neklason ◽  
Miguel A. Rodriguez-Bigas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lynch Syndrome ◽  
Early Onset ◽  
Early Onset Colorectal Cancer

P.17.2 IS EARLY-ONSET COLORECTAL CANCER A VALID MARKER TO IDENTIFY LYNCH SYNDROME?

2012 ◽  
Vol 44 ◽  
pp. S197-S198
Author(s):  
L. Sanchez Mete ◽  
M. Diodoro ◽  
B. Casini ◽  
A. Martayan ◽  
M. Anti ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lynch Syndrome ◽  
Early Onset ◽  
Early Onset Colorectal Cancer

Disease characteristics and treatment outcomes of young colorectal cancer patients.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 691-691 ◽  
Author(s):  
Hiral D. Parekh ◽  
Yu Wang ◽  
Wissam Hanayneh ◽  
Miles Cameron ◽  
Sanda Tan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Treatment Outcomes ◽  
Early Stage ◽  
Young Patients ◽  
Study Cohort ◽  
Chi Square ◽  
Perioperative Therapy ◽  
Cancer Specific Survival ◽  
Disease Characteristics ◽  
Cox Proportional Hazard Regression

691 Background: The incidence of colorectal cancer (CRC) in young patients (< 50 years) is increasing but little is known about disease characteristics and treatment outcomes in this patient population. Methods: CRC patients diagnosed at < 50 years of age (UF institutional registry 2000-2017) constituted the IRB approved study cohort. Statistical methods included descriptive statistics, uni-variable cox proportional hazard regression model, Pearson chi-square exact and Wilcoxon rank-sum test. Results: The median age at diagnosis was 45 years (range 17-50, n = 286) with 212 (74%) diagnosed between age 40-50. One third (35.7%) of patients had rectal primary and most common histology was adenocarcinoma (ACa, 84.6%) and 20% of those had poorly differentiated tumor. More than half of patients had an advanced primary (T3/T4, 65%) and 44% had lymph node positive disease. A trend towards increased delivery of perioperative therapy was seen in early staged disease. (See table) Patients who underwent curative resections had better hemoglobin (p = 0.005) and albumin levels (Alb, p < 0.001) and lower CEA level (p < 0.001). Factors associated poor survival were low alb levels ≤ 34 g/l, advanced primary tumor (T3/T4), nodal disease (N1/N2) and presence of diffuse metastasis. For stage 4 disease, the cancer-specific survival (CSS) at 1 year was 77.2%, 3-year CSS was 46.1% and 5-year CSS was 29%; survival was better (HR = 0.4; 95% CI 0.2-0.6, p < 0.001) among patients who underwent metastatectomy. Conclusions: Our data suggests that younger CRC patients were more likely to be managed in an aggressive manner with a higher proportion of early stage patients receiving perioperative therapy. A suggestion of an improved CSS was seen in advanced stage disease even with similar prognostic factors. Review of larger datasets are warranted. [Table: see text]

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