HEMATOCHEZIA and abdominal pain are the initial symptoms in nearly half of individuals with early-onset colorectal cancer (EOCRC), according to recent research. EOCRC, defined as colorectal cancer diagnosed in individuals younger than 50 years, is an increasingly prevalent condition. The identification and timely diagnosis of EOCRC are critical due to often missed red flag signs and symptoms, leading to significant delays in diagnosis. Recent research has determined the most common presenting signs and symptoms of EOCRC, their association with EOCRC risk, and the average time from initial presentation to diagnosis.
A comprehensive search of PubMedMEDLINE, Embase, CINAHL, and Web of Science databases was conducted through May 2023. Inclusion criteria focused on studies reporting signs and symptom presentation or diagnostic delays in patients under 50 years diagnosed with non-hereditary colorectal cancer. The analysis included 81 studies with a total of 24,908,126 patients. Data extraction and quality assessment were performed using Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. The analysis revealed that hematochezia (45%; 95% CI: 40-50%), abdominal pain (40%; 95% CI: 35-45%) and altered bowel habits (27%; 95% CI: 22-33%), were the most common presenting symptoms. The mean time from symptom presentation to diagnosis was 6.4 months, with a median of 4 months, indicating a substantial diagnostic delay.
The results demonstrate that nearly half of patients with EOCRC present with hematochezia and abdominal pain, and one-quarter with altered bowel habits, highlighting the significance of these symptoms in early detection. The observed diagnostic delays, averaging 4-6 months, suggest a need for improved clinical awareness and protocols to expedite diagnosis. Future efforts should focus on enhancing healthcare provider education and developing robust screening strategies to reduce diagnostic delays and improve clinical outcomes for EOCRC patients.
Katrina Thornber, EMJ
Reference
Demb J et al. Red flag signs and symptoms for patients with early-onset colorectal cancer: a systematic review and meta-analysis. JAMA Netw Open. 2024;7(5):e2413157.
