{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T07:04:37Z","timestamp":1784617477429,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The incidence of early\u2010onset colorectal cancer (CRC), commonly defined as diagnosis prior to age 50, is increasing. Studies of patients diagnosed prior to age 35 as a distinct subset of all early\u2010onset patients have yielded inconsistent results. We extracted prospectively collected data from consecutive patients with metastatic colorectal cancer (mCRC) entered in the multi\u2010site Treatment of Recurrent and Advanced Colorectal Cancer (TRACC) Australasian registry. We focused on comparing demographic and clinicopathologic characteristics of those diagnosed &lt;\u200935Y with remaining early\u2010onset patients (35\u201349Y) whilst including a comparison to older patients (\u2265\u200950Y) as a reference point. Molecular data were examined from 2015 when testing became reflexive. From July 2009 to December 2023, we identified 4399 patients with mCRC, including 133 (3.0%) &lt;\u200935Y, and 537 (12%) 35\u201349Y. The proportion of &lt;\u200935Y among newly diagnosed mCRC increased per calendar year (odds ratio 1.07, 95% CI 1.02\u20131.11). Gender, ECOG performance status and primary tumour location were similar for &lt;\u200935Y and 35\u201349Y. Compared to 35\u201349Y, &lt;\u200935Y had more de novo metastatic disease (79% vs. 70%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.04),\n                    <jats:italic>BRAF<\/jats:italic>\n                    V600E mutations (32% vs. 10%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and deficient mismatch repair (dMMR) tumours (9.8% vs. 2.8%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.008). Rates of chemotherapy, rates of liver resection and overall survival (OS) were similar between &lt;\u200935Y and 35\u201349Y. Multiple differences were observed between &lt;\u2009fand 35\u201349Y, most notably a higher rate of\n                    <jats:italic>BRAF<\/jats:italic>\n                    V600E mutations and dMMR cancers. Collectively, these findings may inform the interpretation of clinical outcomes, refine screening approaches and advance understanding of CRC tumorigenesis in younger patients.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70665","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:40:53Z","timestamp":1784616053000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metastatic Colorectal Cancer Diagnosed Before Age 35: A Distinct Subset of Early\u2010Onset Disease?"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1901-050X","authenticated-orcid":false,"given":"Colin","family":"Williams","sequence":"first","affiliation":[{"name":"Division of Personalised Oncology Walter &amp; Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azim","family":"Jalali","sequence":"additional","affiliation":[{"name":"Division of Personalised Oncology Walter &amp; Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"},{"name":"Department of Medical Oncology Western Health  Melbourne Victoria Australia"},{"name":"Department of Medical Oncology Latrobe Regional Hospital  Traralgon Victoria Australia"},{"name":"Department of Medical Oncology Northern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Personalised Oncology Walter &amp; Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"},{"name":"Department of Medical Oncology St Vincent's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue\u2010Anne","family":"McLachlan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology St Vincent's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Burge","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Hui\u2010Su","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Macarthur Cancer Therapy Centre, Campbelltown Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Caird","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Gold Coast University Hospital  Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace Y.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Personalised Oncology Walter &amp; Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4633-3818","authenticated-orcid":false,"given":"Adnan","family":"Khattak","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Fiona Stanley Hospital\/Edith Cowan University  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Personalised Oncology Walter &amp; Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"},{"name":"Department of Medical Oncology Northern Health  Melbourne Victoria Australia"},{"name":"Department of Medical Oncology Peter MacCallum 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