# Increasing incidence of early-onset colorectal cancer (review)

Source: https://onco.cc/key-papers/paper-sinicrope-early-onset-crc-nejm-2022/  
OnCo record `paper-sinicrope-early-onset-crc-nejm-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

This review explains the rise of colorectal cancer in adults under 50, what is known about its causes and distinct features, and how screening ages and clinical management have responded.

## Summary

Review of the epidemiology of colorectal cancer diagnosed before age 50, including birth-cohort effects, proposed risk factors (obesity, diet, microbiome, antibiotics), clinical and molecular features (left-sided and rectal predominance, later stage at diagnosis, similar mutational profiles in sporadic cases), germline findings, and implications for screening and treatment.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: New England Journal of Medicine
- Year: 2022
- DOI: 10.1056/NEJMra2200869
- Authors: Sinicrope FA.
- What it means: The early-onset colorectal cancer page's emphasis on investigating rectal bleeding at any age, universal germline testing and avoiding treatment escalation on age alone follows this framing.
- Caveats: Causes remain hypotheses; no single exposure explains the trend.

## Sources

- N Engl J Med 2022: https://doi.org/10.1056/NEJMra2200869
- PubMed: https://pubmed.ncbi.nlm.nih.gov/35443109/

## Connected records

- cancers: [Early-onset colorectal cancer (under 50)](https://onco.cc/cancers/early-onset-colorectal/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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