Rising incidence of early-onset colorectal cancer - a call to action.
Rising incidence of early-onset colorectal cancer - a call to action.
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DOI：
10.1038/s41571-020-00445-1
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Ogino S
中科院分区：
文献类型：
--
作者：
Akimoto N;Ugai T;Zhong R;Hamada T;Fujiyoshi K;Giannakis M;Wu K;Cao Y;Ng K;Ogino S
早发性结直肠癌（CRC）常见于50岁以下人群，在世界范围内呈上升趋势，特别是在高收入国家，原因不明。这种上升的合理假设包括暴露于潜在的风险因素，如西式饮食、肥胖、缺乏体育活动和抗生素使用增加，特别是在生命早期从产前到青春期。这些暴露不仅可能导致结直肠上皮细胞的遗传和表观遗传改变，而且还可能影响肠道微生物群和宿主免疫。与晚发性crc相比，早发性crc表现出不同的临床、病理和分子特征。虽然某些现有资源可以用来阐明早发性结直肠癌的病因，并为有效预防、早期发现和治疗策略的发展提供信息，但仍需要进行额外的生命过程队列研究，包括从生命早期到成年早期，结合前瞻性生物标本收集、组学生物标志物分析和分子病理流行病学方法。
Early-onset colorectal cancer (CRC), which occurs in individuals under 50 years of age, has been increasing worldwide, especially in high-income countries, for unknown reasons. Plausible hypotheses for this rise include exposure to potential risk factors such as western-style diet, obesity, physical inactivity, and increased antibiotic use, especially in early life from prenatal to adolescent periods. These exposures may not only cause genetic and epigenetic alterations in colorectal epithelial cells, but also affect the gut microbiota and host immunity. When compared to later-onset CRCs, early-onset CRCs exhibit differential clinical, pathological, and molecular features. While certain existing resources can be utilized to elucidate the etiology of early-onset CRC and inform the development of effective prevention, early detection, and therapeutic strategies, there is a need for additional life-course cohort studies spanning the periods of early-life to young adulthood integrated with prospective biospecimen collections, omics biomarker analyses, and the molecular pathological epidemiology approach.
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