Evelyn Wong: Early Onset Colorectal Cancer – Can we do more?
Evelyn Wong, Medical Oncologist at National Cancer Centre Singapore, shared her recent article on LinkedIn:
“Early – Onset colorectal cancer (EOCRC) – Can we do more?
This week’s TIME cover highlighted something close to my heart: cancer patients are getting younger and younger. This is a global phenomenon that is happening around the world.
Our colorectal cancer team from Singapore General Hospital and National Cancer Centre Singapore Cancer Centre, led by Lionel Chen recently published a population-based study highlighting the trends in EOCRC in Singapore.
Our analysis of incidence trends over time suggests that the rising incidence of EOCRC in Singapore is nuanced. The increasing trend for people under 50 years of age is particularly for rectal cancer, especially in males. This trend also affects, in particular, the Malays and the Chinese, with the Indians being less affected.
Compared to the reference birth cohort of 1950-1954, there was a trend toward a higher incidence rate ratio (IRR) for colon cancer among the 1970-1990 birth cohorts; but, these changes were not statistically significant. However, there was a significant increase in the IRR for rectal cancer among the birth cohorts from 1970 onward, and this peaked in the 1980-1984 birth cohort (IRR 1.35, 95% CI 1.043-1.748).
High consumption of processed meat, alcohol, a sedentary lifestyle, a lack of dietary fiber consumption, smoking, and obesity are known lifestyle factors associated with CRC. However, these modifiable risk factors are present in all age groups and not specific to young individuals and cannot explain fully the rising incidence among young people. Microbiome has long been implicated with recent studies showing an increase in Fusobactrium spp. in the microbiome of EOCRC.
Truth is, I do remember my young patients well. I relate to their fervour in life; and the hope they carry with them through their treatment. The care of early-onset cancer patients becomes complex even beyond medicine. The upshot of all this: understanding WHY will take years, if not decades, to figure out what is causing early-onset cancer and perhaps even more time to figure out how to stop them. AI and digital technologies may help to identify these factors faster but large population studies, over time, are necessary to understand the biological and molecular triggers.”
Authors: Hui Lionel Raphael Chen, et al.
-
ESMO 2024 Congress
September 13-17, 2024
-
ASCO Annual Meeting
May 30 - June 4, 2024
-
Yvonne Award 2024
May 31, 2024
-
OncoThon 2024, Online
Feb. 15, 2024
-
Global Summit on War & Cancer 2023, Online
Dec. 14-16, 2023