Genomic and molecular landscape of early onset colorectal cancer: Emerging insights and clinical implications-A systematic review.
SurgeryJul 2, 2026 (epub)
Ilektra Kyrochristou, Gerasimia Kyrochristou, Georgios Anagnostopoulos et al.
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In 30 seconds
This systematic review analyzed the genomic and molecular characteristics of early onset colorectal cancer (EOCRC) in approximately 19,888 patients. It found that EOCRC is a distinct entity with unique genomic profiles, showing lower B-Raf mutations and higher rates of tumor protein p53 alterations compared to late-onset cases. The study emphasizes the need for tailored risk assessment and screening strategies.
Key findings
- EOCRC predominantly occurs in distal and rectal sites, with a slight male bias and higher prevalence in Hispanic and Asian populations.
- Compared to late-onset colorectal cancer, EOCRC has lower B-Raf V600E mutation rates but higher tumor protein p53 alterations.
- Distinct comutation patterns and overexpression of immediate-early response genes characterize the transcriptional landscape of EOCRC.
- Genomic instability in EOCRC is driven by tumor protein p53 alterations and defective DNA repair mechanisms.
Why it matters
Understanding the unique molecular landscape of early onset colorectal cancer is crucial for developing age-specific screening protocols and targeted therapies, potentially improving patient outcomes.