European journal of medical research · 2025
Early-onset colorectal cancer: a retrospective study of demographic, clinicopathological, and molecular characteristics in a single Chinese center.
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Chen Zongyao, Ye Linhan, Liu Yuhang, Geng Menghang, Deng Shuangya, Chen Weidong
Аннотация
BACKGROUND: Early-onset CRC is typically defined as CRC diagnosed in individuals under the age of 50 years. The global incidence and mortality rates of early-onset CRC have gradually increased. The clinicopathological features and pathogenesis of early-onset CRC have still not been fully elucidated, and related data are lacking in China. This research aimed to examine the demographic and clinicopathological characteristics of early-onset CRC patients in China.
MATERIALS AND METHODS: This retrospective study included all patients newly diagnosed with CRC between 2019 and 2021 in the General Surgery Department of the Second Xiangya Hospital, Central South University.
RESULTS: A total of 1206 CRC cases were included. Among them, 180 cases (14.9%) were early-onset CRC, and 1026 cases were late-onset CRC, all of which were collected and analyzed. Early-onset CRC patients had significantly longer median symptom durations (90 vs. 60 days, P < 0.001). Patients with late-onset CRC less commonly had a family history than patients with early-onset CRC did (25.60% vs. 17.93%, P = 0.022). There was no direct relationship between symptom duration and disease stage at presentation in early-onset CRC patients (P = 0.750). Early-onset CRC patients were more likely to present with advanced disease (stage IV) compared to late-onset CRC patients (24.44% vs. 13.45%, P < 0.001). Additionally, early-onset CRC patients were more likely to present with poorly differentiated tumors (29.81% vs. 12.70%, P < 0.001) and with mucinous or signet-ring cell histology (22.40% vs. 14.17%, P = 0.011) compared to late-onset CRC patients. Deficient mismatch repair (dMMR) tumors were more common in early-onset CRC patients (15.90% vs. 6.28%, P < 0.001). Among early-onset CRC patients, no significant differences were observed in age, sex, BMI, or tumor pathology between those with right-sided and left-sided tumors.
CONCLUSIONS: Early-onset CRC has different epidemiology, pathology, and molecular features than late-onset CRC in China. More research is needed to better understand the pathophysiology of early-onset CRC and why there are different characteristics between the two types of CRC.
MATERIALS AND METHODS: This retrospective study included all patients newly diagnosed with CRC between 2019 and 2021 in the General Surgery Department of the Second Xiangya Hospital, Central South University.
RESULTS: A total of 1206 CRC cases were included. Among them, 180 cases (14.9%) were early-onset CRC, and 1026 cases were late-onset CRC, all of which were collected and analyzed. Early-onset CRC patients had significantly longer median symptom durations (90 vs. 60 days, P < 0.001). Patients with late-onset CRC less commonly had a family history than patients with early-onset CRC did (25.60% vs. 17.93%, P = 0.022). There was no direct relationship between symptom duration and disease stage at presentation in early-onset CRC patients (P = 0.750). Early-onset CRC patients were more likely to present with advanced disease (stage IV) compared to late-onset CRC patients (24.44% vs. 13.45%, P < 0.001). Additionally, early-onset CRC patients were more likely to present with poorly differentiated tumors (29.81% vs. 12.70%, P < 0.001) and with mucinous or signet-ring cell histology (22.40% vs. 14.17%, P = 0.011) compared to late-onset CRC patients. Deficient mismatch repair (dMMR) tumors were more common in early-onset CRC patients (15.90% vs. 6.28%, P < 0.001). Among early-onset CRC patients, no significant differences were observed in age, sex, BMI, or tumor pathology between those with right-sided and left-sided tumors.
CONCLUSIONS: Early-onset CRC has different epidemiology, pathology, and molecular features than late-onset CRC in China. More research is needed to better understand the pathophysiology of early-onset CRC and why there are different characteristics between the two types of CRC.