One of the most alarming recent health trends is the rise in “early-onset cancers”—those diagnosed in adults between the ages of 18 and 49. Advancing age is the top risk factor for cancer in general.
Many individuals in this age group are too young for recommended routine cancer screenings—for example, mammography screening typically starts at age 40 and colonoscopies at age 45. And busy lives make it difficult to keep up with routine primary care visits.
Now, a study analyzing the sex-specific differences in survival among early-onset colorectal cancer (EOCRC) patients has compared sex-specific predictors of survival in both males and females in the United States. They found that males had significantly worse overall survival, cancer-specific survival, and noncancer-specific survival in comparison to females.
They wrote, “Further understanding of the epidemiological and genetic bases of these differences could facilitate targeted, personalized therapeutic approaches for EOCRC.”
The study appeared in Nature last week, and the lead author is Abdelrahman Yousry Afify, School of Medicine, New Giza University, Egypt.
Colorectal cancer has become the number one cause of cancer death for men under 50 and the number two cause of cancer death in women in that age group. With more than 50,000 reported deaths in 2024, following lung and bronchus cancer. An estimated 150,000 new cases have been diagnosed correspondingly, with a slight shift towards males compared to females.
EOCRC, the authors wrote, exhibits more restricted pathological features and symptoms in comparison to late-onset colorectal cancer (LOCRC). Accordingly, patients are less likely to seek immediate medical care. The current upward trend has not been fully accounted for by various driving environmental and genetic risk factors with limited understanding of the precise epidemiology of EOCRC. However, the current belief is that the epidemiological profile of EOCRC patients is distinct from that of other patients.
The team retrieved and analyzed data from the Surveillance, Epidemiology, and End Results (SEER) program for EOCRC patients, between the ages of 20 and 49. The study included 58,667 EOCRC patients (27,662 females, 31,005 males) diagnosed between 2000 and 2017. The baseline characteristics at the time of diagnosis were significantly heterogeneous between males and females.
Analysis of this data showed males had significantly worse overall survival, cancer-specific survival, and noncancer-specific survival in comparison to females in both the general cohort, and the matched cohort.
Predictors of survival outcomes generally followed a similar pattern in both sexes except for minor differences. The team identified sex as an independent prognostic factor of EOCRC, suggesting disparities in survival between sexes.
