{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:54:51Z","timestamp":1792716891870,"version":"4.5.0"},"reference-count":183,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence of early-onset (EO) gastrointestinal (GI) cancers\u2014commonly defined as being diagnosed in patients &amp;lt;50 years of age\u2014is rising at an alarming rate globally. The rising incidence demonstrates a birth cohort effect, implicating environmental factors, such as diet and lifestyle; however, the drivers behind this trend are not yet known.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive narrative review of the literature was conducted, focusing on EO colorectal, oesophagogastric, and pancreatic cancers. Additionally, the literature on less common EO GI cancers, including appendiceal, biliary, and neuroendocrine tumours, was reviewed. Epidemiological trends, risk factors, clinical and molecular characteristics, germline and somatic genetic features, and outcomes across these diseases were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>EO GI cancers have demonstrated a consistent rise in incidence, which disproportionally affects black, Hispanic, and indigenous populations and women. Though germline pathogenic variants are more common in EO GI cancers compared with average-onset GI cancers, most cases occur sporadically. Modifiable risk factors associated with an increased risk of EO GI cancers include obesity, a Western-pattern diet, non-alcoholic fatty liver disease, smoking, and alcohol use, among others. Across GI cancers, younger patients frequently present with more aggressive disease features and receive more intensive treatment compared with older patients. Survival outcomes are inconsistent across studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EO GI cancers represent clinically distinct disease entities that are associated with unique challenges in screening, management, and survivorship. A better understanding of underlying aetiologies, optimized screening strategies, and improved survivorship support are necessary. Meeting the needs of this growing patient population will require a multidisciplinary, equity-based approach in both clinical care and research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znaf102","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T05:40:30Z","timestamp":1744868430000},"source":"Crossref","is-referenced-by-count":15,"title":["Early-onset gastrointestinal cancers: comprehensive review and future directions"],"prefix":"10.1093","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1945-7487","authenticated-orcid":false,"given":"Sara K","family":"Char","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine A","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0631-1494","authenticated-orcid":false,"given":"Kimmie","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"2025070800024699200_znaf102-B1","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1158\/1055-9965.EPI-20-0944","article-title":"Epidemiology and outcomes of young-onset esophageal adenocarcinoma: an analysis from a population-based database","volume":"30","author":"Codipilly","year":"2021","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2025070800024699200_znaf102-B2","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1053\/j.gastro.2020.10.007","article-title":"Worldwide burden of, risk factors for, and trends in pancreatic cancer","volume":"160","author":"Huang","year":"2021","journal-title":"Gastroenterology"},{"key":"2025070800024699200_znaf102-B3","doi-asserted-by":"crossref","first-page":"e2118457","DOI":"10.1001\/jamanetworkopen.2021.18457","article-title":"Global incidence and mortality of gastric cancer, 1980\u20132018","volume":"4","author":"Wong","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2025070800024699200_znaf102-B4","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1002\/cncr.33916","article-title":"Trends in the incidence of early-onset colorectal cancer in all 50 United States from 2001 through 2017","volume":"128","author":"Shah","year":"2022","journal-title":"Cancer"},{"key":"2025070800024699200_znaf102-B5","doi-asserted-by":"crossref","first-page":"2179","DOI":"10.1136\/gutjnl-2019-319511","article-title":"Global patterns and trends in colorectal cancer incidence in young adults","volume":"68","author":"Siegel","year":"2019","journal-title":"Gut"},{"key":"2025070800024699200_znaf102-B6","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.1016\/S2468-2667(18)30267-6","article-title":"Emerging cancer trends among young adults in the USA: analysis of a population-based cancer registry","volume":"4","author":"Sung","year":"2019","journal-title":"Lancet Public Health"},{"key":"2025070800024699200_znaf102-B7","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1038\/s41571-022-00672-8","article-title":"Is early-onset cancer an emerging global epidemic? 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