Abstract PR002: Clinical, pathological, and molecular differences in early- and late-onset colorectal cancer: Results from a multicenter study
Notice bibliographique
Résumé
Abstract Introduction: The incidence of colorectal cancer (CRC) in individuals under 50, referred to as early-onset colorectal cancer (EO-CRC), has risen markedly in recent decades. By 2030, EO-CRC is projected to account for 10.9% of colon and 22.9% of rectal cancers. By contrast, cases diagnosed at ≥50 years are classified as late-onset CRC (LO-CRC), corresponding to the population historically included in routine screening. Because routine screening is not offered to younger adults, EO-CRC is often detected at advanced stages, underscoring the need for tailored prevention and detection strategies. In this study, we investigated clinical, pathological, and molecular differences between EO-CRC and LO-CRC, focusing on stage distribution, tumor location, and DNA methylation profiles, and evaluated the association of age with CRC and adenoma risk. Methods: From 2018 to 2024, a total of 12,520 individuals were enrolled in a multicenter trial conducted in Spain and the United States. The cohort included 4,977 controls, 1,731 with non-advanced adenomas, 2,244 with advanced adenomas, and 3,568 with CRC. Most participants were recruited through average-risk screening colonoscopies (either first-time or surveillance after negative screening, including FIT-based programs), with additional enrollment of EO-CRC cases. For CRC patients, the distribution of tumors by stage and location was assessed. Odds ratios (ORs) were estimated to determine adenoma and CRC risk EO-CRC and LO-CRC. DNA methylation was analyzed by comparing average methylation frequency (AMF) between groups using the Mann-Whitney U test. Results: A total of 140 CRC cases were diagnosed in patients <50 years versus 3,428 in ≥50. EO-CRC patients more frequently presented with stage IV disease (22.8% vs. 12.1% in LO-CRC). Tumor distribution also differed significantly by age: EO-CRC was more often located in the distal colon (54.5% vs. 39.4% in LO-CRC) and rectum (23.6% vs. 19.2%), whereas LO-CRC was predominantly proximal (39.8% vs. 22.0% in EO-CRC). No significant association was found between age <50 and advanced adenomas (OR 0.94, p=0.54). CRC risk increased progressively with age (OR 1.24 at 50–59 to OR 3.88 at 80–89). Nevertheless, individuals <50 years had 22% higher odds of CRC compared with older groups (OR 1.22). Methylation analyses revealed significantly higher EO-CRC AMF values than age-matched controls (p=9.2e-03), with more substantial differences than those observed in LO-CRC. Conclusion: CRC risk escalates with age, yet EO-CRC is disproportionately diagnosed at advanced stages and in distal/rectal sites. Younger patients also display distinct methylation alterations, supporting a divergent tumor biology. These findings highlight the need for heightened awareness, refinement of risk stratification, and consideration of earlier screening or molecular-based surveillance in younger populations. Citation Format: NASTARAN Riahi Dehkordi, Carme D. Nolla Colomer, Francesco D. Mattia Mancuso, Kristi Kruusmaa. Clinical, pathological, and molecular differences in early- and late-onset colorectal cancer: Results from a multicenter study [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: The Rise in Early-Onset Cancers—Knowledge Gaps and Research Opportunities; 2025 Dec 10-13; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(23_Suppl):Abstract nr PR002.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».