Early-onset colorectal cancer (under 50): lines of therapy
5 standard-of-care settings across 4 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
| Line | All comers |
|---|---|
| Screening, prevention and diagnosis | 2 |
| Early / localised | 1 |
| Advanced, first line | 1 |
| Special situations | 1 |
Screening, prevention and diagnosis
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Screening and early diagnosis | Average-risk screening from age 45 (colonoscopy, faecal immunochemical test, stool DNA or blood test); earlier and more frequent colonoscopy for family history or a known syndrome; investigate rectal bleeding and iron deficiency promptly at any age. | NCCN Guidelines: Colon Cancer | 79 | |
| All comers | Diagnosis and staging | Germline multigene testing for every patient; mismatch repair, RAS, BRAF and HER2 testing; fertility counselling before treatment. | NCCN Guidelines: Colon Cancer | 95 |
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Localised disease | As for colorectal and rectal cancer by stage: surgery, adjuvant FOLFOX or CAPOX for stage III, total neoadjuvant therapy or organ preservation for rectal tumours; no escalation on the basis of age alone. | NCCN Guidelines: Colon Cancer | 82 |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Metastatic disease | Genotype-directed therapy as for all metastatic colorectal cancer: checkpoint blockade if mismatch-repair deficient, encorafenib-cetuximab for BRAF V600E, HER2 or KRAS G12C combinations, otherwise chemotherapy with bevacizumab or an anti-EGFR antibody by sidedness. | NCCN Guidelines: Colon Cancer | 98 |
Special situations
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Survivorship | Structured exercise (CHALLENGE), long-term neuropathy and bowel function care, fertility and sexual health follow-up, financial and employment support. | NCCN Guidelines: Colon Cancer | 79 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.