In recent years, digestive oncology patients have changed their profile. In certain expert centers, young subjects (20 to 49 years old) can now represent a third, or even half, of hospitalized patients, as in Gustave-Roussy. In the United States, young patients represent 20% of colon cancer cases, compared to 11% in 2011.
The rejuvenation of patients affected by cancer remains without formal explanation, hereditary forms and family history not explaining the increase. A difference in location is noted, with a tendency to tumors of the rectum and left colon in young people. The clinical presentation is classic, but with a propensity for greater severity, with cancers more often metastatic and more aggressive characteristics, due to a diagnostic delay of a few months. Initially, anemia in a woman will be attributed to menstruation and digestive bleeding will suggest hemorrhoids.
The absence of family history should not exclude the hypothesis of cancer. “ You need to know that it exists and not ignore symptoms such as unexplained weight loss, persistent anemia or recurring pain, without going to the scanner straight away of course. Attending physicians are in a delicate situation, they must sort things out and choose when to worry », adds Dr Alice Boilève, digestive oncologist at Gustave-Roussy. Treating young people involves choices of care taking into account fertility, pregnancy plans, functional after-effects, etc.
At Gustave-Roussy, the Yoda project seeks to research the multifactorial origins of digestive cancers in young people and aims to define what actions can be implemented to reduce their incidence. This program offers molecular profiling of the tumor as well as a genetic consultation, even without a family history.
Wang S et al. The Lancet Gastroenterology & Hepatology 2024. DOI : 10.1016/S2468-1253(23)00366-7
Patel VR et al. Ann Int Med 2024. DOI : 10.7326/ANNALS-24-0063
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