Left-Sided Dominance of Early-Onset Colorectal Cancers: A Rationale for Screening Flexible Sigmoidoscopy in the Young

Segev, Lior; Kalady, Matthew F.; Church, James M.

doi:10.1097/dcr.0000000000001062

Cited by 58 publications

(37 citation statements)

References 21 publications

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“…Rho et al compared CRC of young (18–44 years) and late (age >44 years) onset [15] and reported that young-onset CRC patients had more aggressive disease, although the treatment patterns and survival outcomes were similar to those of the late-onset group. Segev et al classified patients using a cut-off age of 50 years, reporting that left-sided CRC was dominant in both groups [20]. Thus, they suggested that patients should be offered sigmoidoscopy at 40 years of age.…”

Section: Discussionmentioning

confidence: 99%

Differences in biological behaviors between young and elderly patients with colorectal cancer

Cheong

Kim

et al. 2019

PLoS ONE

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Background We investigated the differences in biological behaviors of sporadic colorectal cancer (CRC) between young and elderly patients. CRC is a common cancer, with a mean age at onset of > 65 years. However, recent reports indicate increasing rates in younger populations. The biological behaviors of sporadic CRC in elderly patients could differ from those in young patients. Methods Between September 2007 and August 2012, we selected 723 CRC patients from our institution. The patients were divided into Group Y (n = 127, aged ≤50 years) and Group O (n = 596, aged >50 years). The clinicopathologic and oncologic outcomes in the two groups were compared. Results Group Y tumors were characterized by higher incidences of mucin production (13.4% vs. 6.7%; P = 0.017), high microsatellite instability (MSI-H) (19.8% vs. 5.2%; P < 0.001), and N2 stage (32.3% vs. 22.1%; P = 0.020) than those in Group O. The recurrence rates were similar in both groups (14.9% vs. 17.3%; P = 0.665). The 5-year overall survival and disease-free survival did not differ. Multivariate analysis indicated that cellular differentiation and pathologic stage were significant prognostic factors for 5-year overall survival. Conclusion Although age was not a prognostic factor for overall survival and young patients did not show a worse prognosis, there were differences in mucin production, MSI-H, and N2 stage between the two groups. Further studies are needed to clarify the clinical and biological characteristics of CRC, improve its treatment strategies, and promote better outcomes in young patients.

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Section: Discussionmentioning

confidence: 99%

Differences in biological behaviors between young and elderly patients with colorectal cancer

Cheong

Kim

et al. 2019

PLoS ONE

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“…Based on these facts, and considering the high diagnostic yield of CT imaging and the development of accurate pathological finding for colon cancer, the utility of routine colonoscopy in patients after treatment of acute right colon diverticulitis, in the absence of complications, such as perforation, abscess formation, and/or obstruction, has been questioned [10]. It has also been questioned if the incidence of colorectal cancer at younger ages is indeed more common on the left than on the right colon [6]. .…”

Section: Discussionmentioning

confidence: 99%

“…Generally, the American Cancer Society guideline recommends colonoscopy surveillance to begin at the age of 45 years [5]. Moreover, the onset of colon cancer at a younger age is more likely to occur in the left than right colon [6]. Considering these points, it is unclear how routine colonoscopy evaluation after right colon diverticulitis could be of clinical benefit with regard to diagnostic performance and economic burden.…”

Section: Introductionmentioning

confidence: 99%

Routine colonoscopy may not be needed for uncomplicated acute right colonic diverticulitis

Lee

Lee²,

Park

et al. 2020

Preprint

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BACKGROUND Routine colonoscopy is recommended to determine the coexistence of colon cancer after medical treatment for colon diverticulitis. However, in the case of uncomplicated diverticulitis diagnosed by computed tomography imaging, the clinical relevance of routine follow-up colonoscopy has recently been debated. Yet, the role of follow-up colonoscopy for right colon diverticulitis, which tends to develop at a younger age than left colon diverticulitis, has not been specifically evaluated. Therefore, or aim in this study was to evaluate the incidence of colon cancer, detected by routine colonoscopy, after conservative management of acute uncomplicated right colon diverticulitis. METHODS Included were patients with uncomplicated right colon diverticulitis (modified Hinchey stage Ia) diagnosed by computed tomography imaging, between 2011 and 2017, and who underwent follow-up colonoscopy surveillance after treatment. The primary outcome was the incidence of colon cancer, with the detection rate of adenoma being the secondary outcome. Information for analysis was retrieved, retrospectively, from patients’ medical records. RESULTS The study group included 330 consecutive patients, with a mean age of 41.9 years, and 51.9% being men. For the primary outcome, the rate of colon cancer on follow-up colonoscopy was 0.3% (1/330 cases). The rate of adenoma detection was 20.3% (67/330 cases), with advanced adenoma identified in 9 of these cases (13.4%). CONCLUSION In patients with acute uncomplicated right colonic diverticulitis, routine colonoscopy after conservative treatment may not be necessary.

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“…These karyotypic abnormalities occur in combination with the accumulation of the “classic” driver mutations in CRC such as APC, KRAS, and SMAD4 ( 57 ). CIN in particular has been associated with early-onset CRC, whose incidence has been climbing in recent decades, predominantly in the left colon and rectum ( 2 , 58 ).…”

Section: Molecular Pathogenesis Of Rectal Cancermentioning

confidence: 99%

“…Colorectal cancer (CRC) is the second highest cause of cancer-related mortality in Europe with an estimated 500,000 cases in 2018 ( 1 ). Approximately one-third of all newly diagnosed CRC is composed of rectal cancer with the incidence rising in younger patients throughout the western world ( 2 ). The principal neoadjuvant treatments consist of neoadjuvant short-course radiotherapy and long-course chemoradiation (nCRT) ( 3 – 6 ).…”

Section: Introductionmentioning

confidence: 99%

Delivery of Personalized Care for Locally Advanced Rectal Cancer: Incorporating Pathological, Molecular Genetic, and Immunological Biomarkers Into the Multimodal Paradigm

2020

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Left-Sided Dominance of Early-Onset Colorectal Cancers: A Rationale for Screening Flexible Sigmoidoscopy in the Young

Cited by 58 publications

References 21 publications

Differences in biological behaviors between young and elderly patients with colorectal cancer

Differences in biological behaviors between young and elderly patients with colorectal cancer

Routine colonoscopy may not be needed for uncomplicated acute right colonic diverticulitis

Delivery of Personalized Care for Locally Advanced Rectal Cancer: Incorporating Pathological, Molecular Genetic, and Immunological Biomarkers Into the Multimodal Paradigm

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