Colorectal
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See the full rubric →Nonoperative Management in Patients With Early-Onset Rectal Adenocarcinoma: A Retrospective Cohort Study.
Clinical takeawayConsider nonoperative management and active surveillance for early-onset rectal cancer patients (<50) who achieve complete response to neoadjuvant therapy, as oncological outcomes are comparable to or better than those in older age groups.
What it foundEarly-onset rectal cancer patients (<50) had a 3-year local regrowth rate of 23.8% (95% CI: 15.2-32.4), similar to middle-aged (33.0%) and late-onset (26.1%) groups (p=0.395), and superior disease-specific survival compared to late-onset patients.
ContextConfirms that nonoperative management is safe and effective in early-onset rectal cancer, aligning with current practice for older patients, and suggests potential survival benefits in younger patients.
Emergingsuggested applicable standard· U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017
Decision at stakewhether to consider nonoperative management for early-onset rectal cancer patients
U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017 · reviewed 2026-07-23 ↗Begin average-risk colorectal cancer screening at age 45 using a patient-centered shared-decision modality choice, colonoscopy every 10 years (preferred) or annual FIT as Tier 1 options, with multi-target stool DNA every 3 years, CT colonography every 5 years, or flexible sigmoidoscopy every 5 to 10 years as Tier 2 alternatives. A positive stool-based test requires diagnostic colonoscopy, and stool tests should not be ordered for patients who would decline follow-up colonoscopy. Generally stop at age 75 with individualized decisions for ages 76-85 and no screening beyond 85.
Rosen RY … Smith JJ · Diseases of the Colon and Rectum · IF 3.5 · PubMed ↗