Written by Mary Marschner
Spoon Feed
Patients diagnosed with colorectal cancer before age 50 likely do not require more frequent surveillance colonoscopies.
Young CRC – one and done?
Colorectal cancer continues to develop in younger populations. Guidelines now recommend starting colonoscopy at 45, yet we don’t have specific guidelines on when to do surveillance colonoscopies after treatment. At this time, we don’t understand why patients are developing colorectal cancers at a younger age or if this younger generation with colorectal cancer is more likely to develop colorectal cancer throughout their lives.
In this retrospective cohort study, early-onset colorectal cancer (EOCRC) (< 50 years) and average-onset CRC (≥ 50 years) patients were compared. There were no significant differences in recurrence or advanced neoplasia detection between groups (P = 0.87), supporting standard surveillance intervals for EOCRC patients. This was a retrospective, single-center study, and – again – we have no guidelines on when surveillance colonoscopy should be done.
How does this change my practice?
This study doesn’t change my current practice, which consists of being on high alert to find colorectal cancers at any time, but I found it extremely interesting, as it suggests that just because a young person developed colorectal cancer doesn’t mean they will again after treatment. I don’t think I’m alone in suspecting that changes in diet or environmental toxins may be playing a role in early cancers. However, if it were that simple, I would suspect CRC to continue to develop even after treatment. This study made me pause and think a bit more broadly about why this could be happening.
Source
Early-onset Colorectal Cancer Patients Do Not Require Shorter Intervals for Post-surgical Surveillance Colonoscopy. Clin Gastroenterol Hepatol. 2024 Dec;22(12):2517-2525.e3. doi: 10.1016/j.cgh.2024.04.029. Epub 2024 May 9. PMID: 38729386
