Rising incidence of early-onset colorectal cancer — a call to action

Naohiko Akimoto, Tomotaka Ugai, Rong Zhong, Tsuyoshi Hamada, Kenji Fujiyoshi, Marios Giannakis, Kana Wu, Yin Cao, Kimmie Ng, Shuji Ogino

Research output: Contribution to journalArticlepeer-review

99 Scopus citations


The incidence of early-onset colorectal cancer (CRC), which occurs in individuals <50 years of age, has been increasing worldwide and particularly in high-income countries. The reasons for this increase remain unknown but plausible hypotheses include greater exposure to potential risk factors, such as a Western-style diet, obesity, physical inactivity and antibiotic use, especially during the early prenatal to adolescent periods of life. These exposures can not only cause genetic and epigenetic alterations in colorectal epithelial cells but also affect the gut microbiota and host immunity. Early-onset CRCs have differential clinical, pathological and molecular features compared with later-onset CRCs. Certain existing resources can be utilized to elucidate the aetiology of early-onset CRC and inform the development of effective prevention, early detection and therapeutic strategies; however, additional life-course cohort studies spanning childhood and young adulthood, integrated with prospective biospecimen collections, omics biomarker analyses and a molecular pathological epidemiology approach, are needed to better understand and manage this disease entity. In this Perspective, we summarize our current understanding of early-onset CRC and discuss how we should strategize future research to improve its prevention and clinical management.

Original languageEnglish
Pages (from-to)230-243
Number of pages14
JournalNature Reviews Clinical Oncology
Issue number4
StatePublished - Apr 2021


Dive into the research topics of 'Rising incidence of early-onset colorectal cancer — a call to action'. Together they form a unique fingerprint.

Cite this