Abstract B004: The Cleveland Clinic’s Young-Onset Colorectal Cancer Center and Registry: Integrating multidisciplinary clinical care and research infrastructure
Bibliographic record
Abstract
Abstract Incidence and mortality rates of young-onset colorectal cancer (YOCRC) have risen over the past three decades, compared to a decline in those over 50. YOCRC patients are often diagnosed at more advanced stages and require more aggressive treatment than their older counterparts. To address this alarming trend, the Cleveland Clinic established The Edward J. DeBartolo Jr. Family Center for Young-Onset Colorectal Cancer in 2021, along with a registry to facilitate research. Eligible participants include Cleveland Clinic patients with a current or past history of colorectal adenocarcinoma diagnosed at >18 and <50 years, along with healthy controls <50 years undergoing diagnostic colonoscopy for symptoms or screening colonoscopy (45-49) with findings negative for neoplasia and without a personal history of polyps, familial cancer syndrome, inflammatory bowel disease, or previous cancer diagnosis. YOCRC patients are approached by a research coordinator during a surgical or oncology visit. Controls are approached either in clinic or virtually ahead of a colonoscopy procedure. Consented participants complete an epidemiologic survey, authorize medical record access, and donate biospecimens (cases: blood, tumor and normal tissue, and stool; controls: blood and normal tissue biopsies). A REDCap database houses demographic and clinical details (e.g., staging, treatment, multidisciplinary resource participation) as well as survey data on diet, physical activity, smoking, quality of life, past medical history, medications, and psychological well-being. To date, the YOCRC Registry has enrolled 593 participants (585 YOCRC cases and 8 controls). For cases, median age at diagnosis was 42.1 years (standard deviation (SD):6.0; range:20.8-49.9), and there were 25 individuals (4.3%) 18-29, 159 (27.2%) 30-39, 170 (29.1%) 40-44, and 231 (39.5%) 45-49 years. The majority were male (56.1%) and reported White race (86.1%; 6.2% Black) and non-Hispanic ethnicity (92.3%). The site distribution was 52.5% colon, 47.7% rectum, and 1.2% appendix. The pathologic stage for resected colon cancer cases was 30 (7.1%) I, 40 (9.5%) II, 91 (21.7%) III, 64 (15.2%) IV, and 195 (46.5%) indeterminate or missing. The clinical stage at diagnosis for rectal cancer cases was 9.0% I, 16.2% II, 49.3% III, and 25.5% IV. The mismatch repair (MMR) status breakdown was 91.5% MMR-proficient, 5.0% MMR-deficient, and 3.5% missing. Multi-gene panel testing was conducted on 77.8%, and 10.7% were diagnosed with a familial cancer syndrome. Control recruitment is rapidly expanding, with mean age of 31.1 years (SD:15.4; range: 20.1-49.4), and 52.5% female, 50% White, and 75% non-Hispanic. The survey response rate to date is 22.1%. Our developing biorepository houses 44 blood, 37 tissue , and 19 stool samples from cases and 8 blood and 6 normal tissue samples from controls. This growing resource supports research to improve patient outcomes and develop early detection strategies for YOCRC. It also uniquely enables etiologic research due to inclusion of healthy younger adult controls. Citation Format: Camila Gonzalez, Jacob Mansell, Sarah McClaren, Phuong Hoa, Christopher Benson II, Eric Cockman, Lisa LaGuardia, Margaret O'Malley, Katherine Knapke, Donald Kirby, Jeremy Lipman, Alberto Rubio Tapia, Michelle K. Kim, Shirley Paski, Michael Goldenschluger, Gilad Alon, Leonardo Duraes, Haniee Chung, Scott Steele, Jonathan Mitchem, Suneel D. Kamath, Kanika G. Nair, Smitha Krishnamurthi, Fredrick R. Schumacher, Alok A. Khorana, Stephanie L. Schmit, David Liska. The Cleveland Clinic’s Young-Onset Colorectal Cancer Center and Registry: Integrating multidisciplinary clinical care and research infrastructure [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 B004.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.030 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.034 | 0.014 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".