Early-Onset Colorectal Cancer: Insights into Molecular Features, Disparities, and Management Challenges

Early-onset colorectal cancer (EOCRC), largely defined as the diagnosis of colorectal cancer in pa-tients younger than 50 years old, has shown a global increase in incidence, which is a growing cause of concern warranting increased awareness and preventive research. The incidence of EOCRC varies with factors like age, gender, and ethnicity, showing the greatest incidence among men, Hispanic patients, and Black patients. Associated risk factors include family history and environmental and lifestyle factors that can lead to long-term changes in the gut microbiome. In EOCRC, there is a preponderance of rectal and left-colonic involvement, a higher proportion of unfavorable histology, and an advanced stage of disease at presentation. Despite efforts to increase awareness, EOCRC patients face worse outcomes, with mortality rates increasing by 1.3% annually, mainly due to a lack of established screening methods. Challenges include financial burdens, fertility risks, and mental health struggles, necessitating multidisciplinary care. Early detection through targeted screening is vital to improve the prognosis of patients with EOCRC. Additionally, healthcare access and EOCRC awareness should be improved for better long-term outcomes.