Study reveals common symptoms, diagnosis delays in early-onset colorectal cancer

Editor's Note

A comprehensive systematic review and meta-analysis, published by JAMA Network on May 24 and encompassing 81 studies and over 24.9 million patients, shed light on the signs and symptoms associated with early-onset colorectal cancer (EOCRC) and highlighted significant delays in diagnosis. The analysis identified the most common presenting signs and symptoms in patients diagnosed with EOCRC, as well as the typical timeframe from symptom onset to diagnosis.

Key findings revealed nearly half of individuals with EOCRC present with hematochezia (45%) and abdominal pain (40%), while a quarter report altered bowel habits (27%). Hematochezia, in particular, shows a strong association with EOCRC, with estimates indicating a 5- to 54-fold increased risk. Abdominal pain and anemia also correlate with higher EOCRC likelihood, further emphasizing the need for timely diagnostic evaluations.

The study highlighted a concerning trend: Diagnostic delays ranging from 4 to 6 months from initial presentation are common. This delay is attributed to factors such as late patient presentation, clinician misattribution of symptoms to less severe conditions, and conservative diagnostic approaches that favor watchful waiting over immediate invasive procedures.

These findings stress the importance of recognizing and responding to EOCRC's red flag signs and symptoms promptly. Improved awareness among clinicians and patients can facilitate earlier detection and intervention, potentially improving clinical outcomes. The study advocates for a more proactive approach in evaluating younger patients presenting with symptoms like hematochezia and abdominal pain, so such cases can receive thorough diagnostic workups—including colonoscopies when necessary—to rule out or confirm EOCRC.

Given the increasing incidence of EOCRC, this research calls for updated clinical guidelines and educational initiatives to better equip healthcare providers in identifying and managing this rising health concern. Ensuring timely diagnosis and treatment is crucial to mitigate the morbidity and mortality associated with EOCRC, the researchers conclude.