Young-onset colorectal cancer: Diagnosis and management

In the U.S., colorectal cancer (CRC) has become the second most incident cancer among adults younger than age 50, and is a leading contributor to cancer deaths in this age group. Young-onset CRC is a heterogeneous disease entity that encompasses etiologies arising from a mix of genetic and environmental factors. Germline predisposition through major hereditary cancer syndromes account for 10-19% of these patients, while familial clustering of risk can be observed in another 23%. The majority of the patients have sporadic CRCs that predominate the left colon and rectum and are typically already nodally or systemically metastatic at diagnosis. The key components of their management include multidisciplinary oncologic care, clinical genetics care, and multidimensional survivorship care. We herein review the epidemiology, the etiologies, and other considerations surrounding the diagnosis and treatment of young-onset CRC. (C) 2018 Elsevier Inc. All rights reserved.