Hereditary colorectal cancer screening: A 10-year longitudinal cohort study following an educational intervention

Addressing the Rising Trend in Early-Age-Onset Cancers in Canada

A multi-disciplinary symposium on early-age onset cancer (EAOC) was held in October 2023 to explore challenges experienced by this rapidly growing population. A major outcome of the symposium was recognition of the remarkable similarities of EAOC patients' journeys across cancer sites. Prevention and early detection of cancer are hindered by a lack of awareness among patients and family doctors that cancer can and does occur in younger persons. Distinct characteristics of the disease-such as a later stage at diagnosis and more aggressive tumor biology-require more potent treatments, which result in profound physical and psychosocial consequences that are unique to this age group. EAOC patient empowerment emerged as another key theme of the symposium. The development of a greater number of specialized clinics was called for, and patient support groups were recognized for the vital role they play in empowering patients and their families. Leading-edge medical advancements hold tremendous hope across the spectrum of EAOC care. New technologies based on genomic profiling, immunotherapy and microbiome alteration contribute to the development of highly effective, personalized approaches to treatment. All symposium participants expressed their commitment to speak with one resounding voice to advocate for equitable access to leading care practices for EAOC patients; thus, a fourth symposium is planned for November 2024.

Breaking Down Barriers to Detection and Care in Early-Age-Onset Colorectal Cancer in Canada

The second Early-Age-Onset Colorectal Cancer Symposium, convened in October 2022, sought solutions to the barriers to early detection and care for colorectal cancer in Canada. This meeting built on a previous symposium, held in 2021 and reported in this journal. Early-age-onset colorectal cancer (EAOCRC) affects increasing numbers of people under the age of 50 in Canada and throughout the developed world. Two main themes emerged from the meeting: the importance of timely detection, and the need for a tailored approach to the care of EAOCRC. Early detection is crucial, especially in light of the later stage at diagnosis and unique tumour characteristics. Symposium participants were strongly in favour of reducing the age of eligibility for screening from 50 to 45, and promoting the development of non-invasive screening techniques such as testing for circulating tumour DNA and biomarkers. Leading approaches to care were described and discussed, which meet the unique treatment needs of younger CRC patients. Multidisciplinary practices within and outside Canada address such factors as fertility, family roles, education, careers and financial responsibilities. These models can be applied in treatment centres across the country.

Early-Age-Onset Colorectal Cancer in Canada: Evidence, Issues and Calls to Action

The inaugural Early-Age-Onset Colorectal Cancer Symposium was convened in June 2021 to discuss the implications of rapidly rising rates of early-age-onset colorectal cancer (EAO-CRC) in Canadians under the age of 50 and the impactful outcomes associated with this disease. While the incidence of CRC is declining in people over the age of 50 in Canada and other developed countries worldwide, it is significantly rising in younger people. Canadians born after 1980 are 2 to 2.5 times more likely to be diagnosed with CRC before the age of 50 than previous generations at the same age. While the etiology of EAO-CRC is largely unknown, its characteristics differ in many key ways from CRC diagnosed in older people and warrant a specific approach to risk factor identification, early detection and treatment. Participants of the symposium offered directions for research and clinical practice, and developed actionable recommendations to address the unique needs of these individuals diagnosed with EAO-CRC. Calls for action emerging from the symposium included: increased awareness of EAO-CRC among public and primary care practitioners; promotion of early detection programs in younger populations; and the continuation of research to identify unique risk factor profiles, tumour characteristics and treatment models that can inform tailored approaches to the management of EAO-CRC.

Awareness regarding early treatment and related factors in first-degree relatives of patients with hereditary colorectal cancer

BACKGROUND

First-degree relatives of patients with hereditary colorectal cancer are a population at high risk for colorectal cancer, but most of them lack correct health knowledge and screening behaviors. Therefore, raising the awareness of early detection, early diagnosis, and early treatment among this population is particularly important in preventing and treating tumors and improving prognosis.

AIM

To analyze the awareness regarding early treatment and related factors in first-degree relatives of patients with hereditary colorectal cancer.

METHODS

A cross-sectional survey method was used to select 200 first-degree relatives of hereditary colorectal cancer patients who were hospitalized at our hospital from June 2017 to March 2021 as the research subjects. A self-made general information questionnaire was used to collect the basic information of the subjects. An awareness questionnaire was used to identify the risk factors that might affect the awareness regarding early treatment of tumors in the first-degree relatives of hereditary colorectal cancer patients through single-factor and multi-factor analyses.

RESULTS

A total of 200 questionnaires were issued, and 196 valid questionnaires were returned, with an effective recovery rate of 98.00%; 127 of the 196 first-degree relatives chose active treatment, accounting for 64.80%, and 50 chose not to actively treat, accounting for 25.51%. The main reasons for active treatment included economic reasons, fear of pain caused by treatment, and time reasons, accounting for 72.00%, 42.00%, and 34.00%, respectively. Non-conditional logistic regression analysis demonstrated that education level (junior high school and below), marital status (unmarried), family per capita monthly income (< 3000 yuan), medical insurance (new rural cooperative medical care/no medical insurance), no commercial medical insurance, number of blood relatives suffering from colorectal cancer (< 4 people), and cognitive level (low recognition) were risk factors affecting the awareness regarding early treatment of tumors in first-degree relatives (odds ratio > 1, P < 0.05).

CONCLUSION

Awareness regarding early treatment needs to be improved among first-degree relatives of hereditary colorectal cancer patients. Factors such as low education, unmarried status, low family monthly income, and no commercial medical insurance may reduce the awareness of early treatment. Therefore, intervention measures should be formulated according to risk factors to enhance the awareness of early treatment.