- Ana Osorio
- Alicia Barroso
- Victoria Fernández
- Verónica García
- Fátima Mercadillo
CRC is the third most frequent type of cancer and the third cause of cancer-related deaths in most developed countries. Age is the main risk factor. The median age at diagnosis is 68 years in men and 72 in women. Since the mid-2000’s, CRC global incidence and mortality in the USA and Europe have been decreasing at an annual rate of 2-3% for both sexes. This decrease is probably related to the extended use of the faecal occult blood test and colonoscopy, which facilitates the removal of precursor lesions, and to the increased awareness among the general population of the preventive and risk factors.
Recent epidemiological studies indicate that CRC incidence in people under 50 is increasing, which is the opposite situation for individuals over 50 years of age. The greater increase was observed in the age range of 40 to 49 years, in which the incidence changed from 18.2 cases population in 1992, to a rate of 26.5 per 100,000 in 2015. This caught the attention of researchers and the general media. Several causal hypotheses were contemplated − new exogenous factors, epigenetic modifications, low-penetrance gene variants and their interactions − and there is a proposal to launch a research agenda to advance knowledge about the aetiological factors and diagnostic methods of early-onset CRC (EOCRC). Since 2010 the Familial Cancer Clinical Unit (FCCU), together with the Surgery Department of the Fundación Jiménez Díaz University Hospital and the Institute for Biomedical Research of Salamanca, has been committed to investigating EOCRC. The aim is to: (i) accelerate research to address unanswered questions about the causes of the increase in EOCRC; and (ii) increase the adoption of evidenced-based practices to identify and manage younger adults at risk for CRC and to facilitate early diagnosis.
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