Behind The Knife: The Surgery Podcast

Clinical Challenges in Colorectal Surgery: Early Onset Colorectal Cancer

Jul 21, 2025
Dr. Andrea Cercek, a gastrointestinal medical oncologist and director of a young-onset GI cancer center, joins Dr. Y. Nancy You, a professor in colon and rectal surgery, to discuss the alarming rise of early-onset colorectal cancer. They explore the importance of new screening guidelines and the implications of MMR-deficient tumors. The conversation highlights the need for genetic counseling, the critical role of multidisciplinary care, and how fertility concerns impact young patients. Their insights shed light on the urgent need for tailored approaches in combating this growing health challenge.
Ask episode
AI Snips
Chapters
Transcript
Episode notes
INSIGHT

Rising Early-Onset Colorectal Cancer

  • Early-onset colorectal cancer (EOCRC) incidence is rising globally, especially in patients under 50.
  • EOCRC often presents as left-sided or rectal tumors and at more advanced stages.
ADVICE

Screening Age And Modalities

  • Start average-risk colorectal cancer screening at age 45 using colonoscopy or stool-based tests.
  • For higher-risk patients, begin screening at age 40 or 10 years before the youngest affected first-degree relative.
INSIGHT

Test Sensitivity And Pragmatism

  • Colonoscopy has the highest sensitivity for cancer and adenomas; FIT-DNA is close for cancers.
  • Use any screening test the patient will complete, especially where colonoscopy access is limited.
Get the Snipd Podcast app to discover more snips from this episode
Get the app