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Expert Discusses Differences Between Early-Onset and Traditional CRC

Danielle Bucco
Published: Monday, Apr 10, 2017

Manish Shah, MD

Manish Shah, MD

Based on the differences in clinical presentation and location of the tumors, researchers believe there are important molecular differences between early-onset and traditional colorectal cancer (CRC). Further follow-up is required to determine the reasons for these differences in tumor genesis and mutational characteristics, says Manish Shah, MD.

at the 2017 AACR annual meeting, Shah, director of gastrointestinal oncology, Weill Cornell Medicine and New York-Presbyterian Hospital, discussed ongoing efforts to understand the distinction between early-onset CRC and traditional CRC.

OncLive: Please discuss how early-onset CRC is distinct from traditional CRC.

Shah: Early-onset CRC seems to be rising in incidence. We have known this for some time, but it's been confirmed on the most recent analysis, creating a main question of why that is the case, which was addressed in this study. 

The final clue was the genomic analysis from TCGA. We looked at the data set that was available to us, which was over 215 colon cancers, and only 15 of them were early-onset, making it a small sample set. In that small sample set, we identified several gene candidates that seemed to make early-onset CRC more prevalent. These were genes in the arachidonic acid/COX pathways.

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