An action plan to address the rising burden of colorectal cancer in younger adults

Burden and Trends of Diet-Related Colorectal Cancer in OECD Countries: Systematic Analysis Based on Global Burden of Disease Study 1990-2021 with Projections to 2050

Background: An unhealthy diet is a major risk factor for colorectal cancer (CRC). This study assessed the diet-related CRC burden from 1990 to 2021 in Organisation for Economic Co-operation and Development (OECD) nations and estimated the burden until 2050. Methods: Data for OECD countries on diet-related CRC disability-adjusted life years (DALYs) and deaths were obtained from the Global Burden of Disease 2021 study. The estimated annual percent change (EAPC) was calculated to analyse the CRC burden attributable to dietary factors. A generalised additive model with a negative binomial distribution was used to predict the future burden of CRC attributable to dietary factors from 2021 to 2050. Results: In 2021, the age-standardised percentages of diet-related CRC DALYs and deaths were 39.1% (95% uncertainty interval (UI): 9.3, 61.3) and 39.0% (95% UI: 9.7, 60.9), respectively, in the OECD countries. Between 1990 and 2021, the age-standardised DALYs decreased from 185 to 129 per 100,000, and deaths decreased from 8 to 6 per 100,000 population for OECD countries. Similarly, the EAPC in the rates showed a downward trend (EAPCdeaths = -1.26 and EAPCDALYs = -1.20). The estimated diet-related CRC DALYs and deaths are projected to increase to 4.1 million DALYs and 0.2 million deaths by 2050. There is a downward trend in CRC deaths (EAPC = 1.33 for both sexes) and in DALYs (-0.90 for males and -1.0 for females) from 1990 to 2050. Conclusions: The diet-related CRC burden remains significant. Implementing nutrition intervention programmes is necessary to promote access to affordable and nutritious foods and raise awareness about the importance of a healthy diet in reducing CRC risk.

Current Status and Emerging Trends in Colorectal Cancer Screening and Diagnostics

Colorectal cancer (CRC) is a prevalent and potentially fatal disease categorized based on its high incidences and mortality rates, which raised the need for effective diagnostic strategies for the early detection and management of CRC. While there are several conventional cancer diagnostics available, they have certain limitations that hinder their effectiveness. Significant research efforts are currently being dedicated to elucidating novel methodologies that aim at comprehending the intricate molecular mechanism that underlies CRC. Recently, microfluidic diagnostics have emerged as a pivotal solution, offering non-invasive approaches to real-time monitoring of disease progression and treatment response. Microfluidic devices enable the integration of multiple sample preparation steps into a single platform, which speeds up processing and improves sensitivity. Such advancements in diagnostic technologies hold immense promise for revolutionizing the field of CRC diagnosis and enabling efficient detection and monitoring strategies. This article elucidates several of the latest developments in microfluidic technology for CRC diagnostics. In addition to the advancements in microfluidic technology for CRC diagnostics, the integration of artificial intelligence (AI) holds great promise for further enhancing diagnostic capabilities. Advancements in microfluidic systems and AI-driven approaches can revolutionize colorectal cancer diagnostics, offering accurate, efficient, and personalized strategies to improve patient outcomes and transform cancer management.

Patterns of Healthcare Utilization Leading to Diagnosis of Young-Onset Colorectal Cancer (yCRC): Population-Based Case-Control Study

Background: The increasing risk of young-onset colorectal cancer (yCRC) in adults < 50 years has called for better understanding of patients’ pathways to diagnosis. This study evaluated patterns of healthcare utilization before diagnosis of yCRC. Methods: Using linked administrative health databases in British Columbia, Canada, we identified yCRC cases and cancer-free controls matched (1:10) on age, sex, and healthcare utilization. The index date was the date of diagnosis for yCRC cases and matched date for controls. Outpatient visits, emergency department visits, and hospitalizations over a 5-year prediagnosis period (e.g., year-1 to year-5) were compared using descriptive statistics and Poisson regression models. Results: The study included 2567 yCRC cases (49.6% females, 43.0 ± 5.8 years) and 25,455 controls (48.6% females, 43.0 ± 5.8 years). We observed an increasing number of outpatient visits from prediagnosis year-5 (median = 3) to year-1 (median = 8) for yCRC cases. Among controls, outpatient visits were stable and did not have a pattern of increase. Poisson regression models indicated higher adjusted count ratios for outpatient visits for yCRC cases compared to controls in the year before diagnosis (1.11; 95% CI, 1.07 to 1.15). In the year before diagnosis, 35.1% of yCRC cases had potentially related visits to CRC (e.g., nausea, vomiting) and 16.9% had potentially red flag visits (e.g., gastrointestinal hemorrhage or iron deficiency anemia). Conclusions: Using population-based data, we found that individuals with yCRC did not have higher healthcare utilization than individuals without in the prediagnosis period except for the year before diagnosis.

Reproductive Health Experiences of Females Diagnosed with Young-Onset Colorectal Cancer: A Multi-Method Cross-Sectional Survey

Objective: Given the increasing risk of young-onset colorectal cancer (yCRC) among adults under 50 years, it is important to understand impacts on reproductive health. Our objective was to assess experiences with reproductive health after yCRC diagnosis among females. Methods: We conducted a cross-sectional study among females, 18 years or older, who have been diagnosed yCRC and are able to communicate in English. Data were gathered using an online survey involving both quantitative (e.g., multiple choice) and qualitative (e.g., open-ended text) questions on pregnancy history, influence of yCRC on reproductive decisions, and experiences with reproductive healthcare. Results: Altogether, 101 females with yCRC participated, including 23 who had never been pregnant and 78 who had been pregnant. yCRC influenced family planning goals for one-third of participants. Furthermore, compared to participants who completed treatment, those currently undergoing treatment had higher odds of indicating their yCRC diagnosis influenced family planning goals (adjusted odds ratio 4.93; 95% confidence interval 1.29 to 18.78). Although 53 (52.5%) participants indicated having discussions regarding reproductive health with healthcare provider(s), 44 (43.6%) did not. Content analysis of open-ended survey questions identified themes on the emotional impacts, experiences with reproductive healthcare, reproductive and family planning considerations, and the related issue of sexual health impacts of yCRC. Conclusions: Gaps in care, related to limited reproductive health discussions, influence of yCRC on family planning, and experiencing lasting reproductive health impacts highlight the need for improving reproductive healthcare, particularly for females diagnosed with yCRC.