Current colorectal cancer (CRC) guidelines recommend surveillance colonoscopies at one year and 48 months after surgical resection, but these guidelines do not account for age at diagnosis. As the incidence of young-onset (diagnosed at or before age 50) CRC has risen worldwide, researchers have hypothesized that patients with spontaneous (non-hereditary) young-onset CRC could have an elevated risk for multiple, independent malignancies, known as metachronous colorectal pathology.
This retrospective, single-institution study, led by Oliver Peacock, B.M.B.S., Ph.D., and Nancy You, M.D., assessed the number of high-risk premalignant lesions, secondary tumors and local recurrences found in 457 young onsets CRC survivors during post-resection surveillance. Among the metachronous colorectal pathology detected, more than half were found around one-year post-resection and another quarter before 48 months. These findings highlight the importance of post-resection surveillance for young-onset CRC patients and support the consideration of an earlier time point for the second surveillance endoscopy in this population.