Department of Veterans Affairs Medical Center, White River Junction, VT and the Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Division of Gastroenterology and Hepatology, University of Connecticut School of Medicine, Farmington, CT, USA.
Expert Rev Gastroenterol Hepatol. 2021 Jun;15(6):623-632. doi: 10.1080/17474124.2021.1876561. Epub 2021 Jan 22.
: While colorectal cancer (CRC) incidence and mortality have decreased for older adults, the rates are increasing in adults younger than 50 years of age in the United States as well as globally. In response to strong epidemiologic evidence as well as sophisticated models, the American Cancer Society (ACS) has recommended screening adults for CRC starting at age 45. Understanding the factors associated with the rise of incidence in adults younger than age 50 may help to identify those adults who may be at greatest risk.: In this review, we provide an overview of the recent literature and discuss possible explanations for the increase in CRC in young adults including obesity and other recognized CRC risk factors, delay in diagnosis of symptomatic patients (<50 years of age), and review perspectives on the current and future status of the field.: Currently there are little data regarding risk factors for CRC in average risk young adults who are asymptomatic. With potential endorsement of screening at 45 years of age by US Preventive Services Task Force, more data regarding clinical and molecular risk factors associated with CRC in young adults will be available.
: 虽然美国和全球范围内 50 岁以下成年人的结直肠癌 (CRC) 发病率和死亡率有所下降，但这一比率在 50 岁以下成年人中仍在上升。为了应对强有力的流行病学证据和复杂的模型，美国癌症协会 (ACS) 建议从 45 岁开始对 CRC 进行筛查。了解与 50 岁以下成年人发病率上升相关的因素可能有助于确定那些风险最大的成年人。: 在这篇综述中，我们提供了最近文献的概述，并讨论了 CRC 在年轻成年人中增加的可能解释，包括肥胖和其他公认的 CRC 风险因素、症状性患者（<50 岁）诊断的延迟，以及对该领域当前和未来状况的回顾。: 目前，对于无症状的普通风险年轻成年人的 CRC 风险因素的数据很少。随着美国预防服务工作组对 45 岁时进行筛查的潜在认可，将有更多关于与年轻人 CRC 相关的临床和分子风险因素的数据。
