In the US, colorectal cancer in children and adolescents is increasingly diagnosed at advanced stages, researchers say

Colorectal cancer remains rare among children and adolescents in the US, but it is being diagnosed more frequently and, in most cases, at an advanced stage. This was the conclusion of researchers whose study was presented at the American Academy of Pediatrics conference in San Diego, HealthDay reports.

The researchers reviewed the medical records of 84 patients under the age of 21 who were diagnosed with colorectal cancer at 34 medical centers between 2012 and 2023. The average age at diagnosis was 16.5 years. About 77% of the tumors originated in the colon, while the remainder were located in the rectum.

More than half of the patients — 51% — were diagnosed with stage III disease, while another 29% already had stage IV disease. Thus, about 80% of cases were diagnosed at an advanced stage. Nearly 37% of patients subsequently experienced a recurrence, while 45.2% had died from colorectal cancer by the end of the study period.

The most common symptoms were abdominal or back pain, reported by 73.8% of patients. Changes in bowel habits occurred in 45.2%, unexplained weight loss in 42.9%, and rectal bleeding in 38.1%. On average, about 12 weeks elapsed between the onset of symptoms and diagnosis.

The authors note that colorectal cancer is rarely considered a possible cause of such symptoms in children and adolescents, which can delay diagnosis. At the same time, only 20.2% of participants reported having a first- or second-degree relative with colorectal cancer. Most patients had no known family history or previously diagnosed syndrome that would increase their risk of the disease.

“Colorectal cancer, unfortunately, is becoming more common among adolescents and young adults,” said lead study author Erica Arnold, a research fellow in pediatric surgery at Nationwide Children’s Hospital. According to her, the disease in adolescents often has an aggressive course, is diagnosed at advanced stages, and is associated with a high risk of recurrence and death.

The researchers urge doctors to consider the possibility of colorectal cancer when symptoms persist, particularly abdominal pain and rectal bleeding, even when the patient is very young.

At the same time, the disease remains extremely rare in this age group: in the US, routine screening for people at average risk generally begins at age 45.

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