Department of Oncology, McMaster University, Hamilton, Ontario, Canada.
Pediatr Blood Cancer. 2019 Nov;66(11):e27941. doi: 10.1002/pbc.27941. Epub 2019 Jul 26.
Colorectal cancer (CRC) incidence is rising among adolescents and young adults (AYAs), with the greatest increase occurring in distal colon and rectal cancers. Reasons for this striking trend are not well understood. Genetically linked cases of CRC occur in the context of familial conditions such as Lynch Syndrome, but most AYA cases of CRC are sporadic. Unique biology is suggested, yet limited information is available regarding the molecular underpinnings of CRC in this age group. Young patients are more likely to experience delays in diagnosis and to present with advanced-stage disease; yet, prognosis by stage is comparable between younger and older adults. Treatment paradigms are based on evidence reflecting the older adult population. Given the concerning rise in CRC rates among AYAs, there is urgent need for further research into the role of screening from a younger age, biology of disease, and optimal therapies in this age group.
结直肠癌（CRC）在青少年和年轻成年人（AYAs）中的发病率正在上升，其中远端结肠癌和直肠癌的发病率增长最大。这种显著趋势的原因尚不清楚。CRC 的遗传性病例发生在 Lynch 综合征等家族性疾病的背景下，但大多数 AYA 结直肠癌病例是散发性的。有人提出了独特的生物学机制，但关于该年龄段 CRC 的分子基础的信息有限。年轻患者更有可能出现诊断延迟，并表现出晚期疾病；然而，年轻患者和老年患者的预后按阶段是可比的。治疗模式基于反映老年人群的证据。鉴于 AYA 中 CRC 发病率的令人担忧上升，迫切需要进一步研究从更年轻时开始筛查、疾病生物学以及该年龄段最佳治疗方法的作用。
