Current Oncology Reports最新文献

{"title":"Tele-Oncology in the Post-Pandemic Era: Clinical Integration, Access Disparities and Medico-Legal Accountability.","authors":"Dimitrios Stylianakis, Serafina Martella, Josie Pearce, Alexia Tomara, Michele Porcu, Christos Tsagkaris, Ioannis Stylianakis, Nerina Denaro, Matteo Lambertini, Luca Saba, Mario Scartozzi, Cinzia Solinas, Marco Soddu","doi":"10.1007/s11912-026-01827-x","DOIUrl":"10.1007/s11912-026-01827-x","url":null,"abstract":"<p><strong>Purpose of the review: </strong>Tele-health has evolved from a marginal tool confined to rural populations and selected follow-up programs into a structurally integrated component of modern cancer care. Prior to COVID-19, its adoption was constrained by regulatory fragmentation, non-uniform reimbursement, and licensure barriers. This narrative review evaluates the evolutionary integration of tele-health in oncology post-COVID-19, examines digital disparities across patient populations, and addresses the medico-legal implications of this integration, with the objective of providing a comprehensive and clinically actionable framework for the governance of virtual oncology care.</p><p><strong>Recent findings: </strong>The pandemic acted as a global catalyst, driving telehealth to over 50% of oncology outpatient encounters in some settings, before stabilising post-pandemic at approximately 10-20% of consultations within hybrid care models. Evidence supports meaningful clinical benefits - improved access to specialist services, reduced travel burden, and sustained continuity of care - with outcomes comparable to in-person care in postoperative follow-up, symptom monitoring, and survivorship. However, persistent disparities in device availability, connectivity, and digital literacy disproportionately affect older, rural, and socioeconomically disadvantaged patients, raising the risk that geographic inequalities are replaced by technological ones. From a medico-legal standpoint, the remote modality does not modify the applicable standard of care, yet restricted physical examination and reliance on patient-reported data introduce risks of diagnostic delay and incomplete clinical assessment, with direct implications for professional liability, data protection under HIPAA and GDPR, cross-border licensure, and multi-party accountability across physicians, institutions, and technology providers. Tele-oncology has become a permanent structural feature of modern cancer care, offering demonstrable benefits in access, continuity, and patient satisfaction. Yet its integration has been uneven, its governance remains fragmented, and its medico-legal landscape is still evolving. Realising the full potential of virtual oncology care - equitably and safely - requires coherent regulatory frameworks, sustained investment in digital infrastructure, and explicit attention to the populations at greatest risk of being left behind.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":"28 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Interventional Oncology in the Management of Neuroendocrine Tumors: 2026 Update.","authors":"Daniel M DePietro, Michael C Soulen","doi":"10.1007/s11912-026-01822-2","DOIUrl":"10.1007/s11912-026-01822-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Summarize recent advances in interventional oncology for the management of neuroendocrine tumor liver metastases (NETLMs), with a focus on evolving evidence for embolization and ablation, integration with systemic therapies, and emerging approaches.</p><p><strong>Recent findings: </strong>Recent studies have strengthened the role of liver-directed therapies within multidisciplinary NET care. Long-term data supports transarterial chemoembolization as an effective and repeatable line of therapy. Improved dosimetry techniques are refining radioembolization's role in NETLM treatment, improving outcomes while limiting long-term toxicities. Synergistic treatment combinations have demonstrated promising efficacy. New evidence for focal therapies, including radiation segmentectomy and histotripsy, may expand options for solitary and oligometastatic disease. Concurrent biopsy and molecular profiling increasingly inform treatment decisions. Interventional radiologists play an increasingly important role in NETLM management by providing tailored and targeted liver-directed therapies, improving patient outcomes, delaying the start of systemic therapies, and integrating with NET treatment plans. Ongoing studies will further define optimal treatment sequencing and patient selection while expanding interventional treatment options.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":"28 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 Receptor Agonists and Obesity Related Cancers: What We Know So Far.","authors":"Naga Praneeth Raja, Nagapavani Kandagari","doi":"10.1007/s11912-026-01825-z","DOIUrl":"10.1007/s11912-026-01825-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obesity increases the risk of at least 13 malignancies. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) produce substantial weight loss and improve metabolic and inflammatory pathways implicated in carcinogenesis. This review critically examines the preclinical, epidemiologic, randomized-trial, and emerging oncology evidence linking these agents to obesity-related cancer incidence and outcomes.</p><p><strong>Recent findings: </strong>Large observational cohorts generally associate GLP-1RA exposure with a lower incidence of composite obesity-related cancers, with relative risk reductions of approximately 7-30% in most diabetes- and obesity-based populations. The most consistent favorable associations have been observed in hepatocellular, colorectal, endometrial, ovarian, and pancreatic cancers. However, these findings remain vulnerable to residual confounding, comparator selection, surveillance bias, and insufficient follow-up. Meta-analyses of randomized trials have not demonstrated a significant reduction in overall cancer incidence and have reported inconsistent site-specific signals, including thyroid and colorectal cancer. Preclinical studies support both indirect metabolic effects and potentially direct tumor and immune effects through insulin/IGF-1, cAMP/PKA, PI3K/Akt/mTOR, AMPK, and NF-κB signaling. Early retrospective studies in patients with active cancer suggest possible associations with improved survival or reduced progression, but causality has not been established. GLP-1RAs should currently be prescribed for approved metabolic indications rather than specifically for cancer prevention or treatment. Their role as metabolic modifiers of cancer risk and outcomes is promising but unresolved. Long-term prospective studies with cancer-specific endpoints, body-composition assessment, and integrated tumor and host biomarkers are needed to identify which populations and tumor types may benefit.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":"28 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head and Neck Rhabdomyosarcoma in Children: An Otolaryngological Perspective on Diagnostic and Therapeutic Approaches.","authors":"Agata Wojno, Milena Chmielewska, Sara Shefa, Oliwia Cichy, Paulina Lenkiewicz, Karolina Dorobisz","doi":"10.1007/s11912-026-01823-1","DOIUrl":"10.1007/s11912-026-01823-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Head and neck rhabdomyosarcoma (HNRMS) is the most common soft-tissue sarcoma in children, with approximately 30-40% of cases arising in the head and neck region. Due to its anatomical complexity, histopathological diversity, and molecular heterogeneity, HNRMS remains a major diagnostic and therapeutic challenge in pediatric otolaryngology. This review aims to summarize current evidence regarding the epidemiology, clinical presentation, diagnostic strategies, contemporary treatment modalities, and long-term complications associated with pediatric HNRMS.</p><p><strong>Purpose of review: </strong></p><p><strong>Recent findings: </strong>Recent advances in molecular pathology have significantly improved risk stratification in rhabdomyosarcoma, particularly through the identification of FOXO1 fusion status as a key prognostic marker. Modern imaging techniques, especially magnetic resonance imaging and PET-based assessment, have enhanced diagnostic precision and evaluation of local tumor extension. Contemporary multimodal treatment protocols combining chemotherapy, conservative surgery, and proton beam radiotherapy have improved survival outcomes while reducing treatment-related morbidity. Furthermore, growing attention has been directed toward survivorship issues, including craniofacial deformities, endocrine dysfunction, hearing impairment, and secondary malignancies. The prognosis of pediatric HNRMS depends strongly on tumor location, histological subtype, and molecular characteristics. Orbital tumors are associated with favorable outcomes, whereas parameningeal lesions continue to pose substantial therapeutic difficulties because of delayed diagnosis and proximity to critical anatomical structures. Early recognition, accurate histopathological and molecular diagnosis, and individualized multidisciplinary treatment are essential to optimize survival and minimize long-term complications. Ongoing developments in targeted therapy and proton radiotherapy may further improve both oncological outcomes and quality of life in affected children. This review is important because it integrates current molecular, diagnostic, and therapeutic advances in pediatric HNRMS from an otolaryngological perspective, highlighting both survival outcomes and long-term quality-of-life considerations. Moreover, it emphasizes the need for early multidisciplinary management in anatomically complex head and neck tumors, which remains crucial for improving prognosis and reducing treatment-related morbidity.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":"28 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal Residual Disease in Head and Neck Cancer: Molecular Surveillance and Clinical Action.","authors":"Sholem Hack, Eran E Alon, Eric Remer","doi":"10.1007/s11912-026-01816-0","DOIUrl":"https://doi.org/10.1007/s11912-026-01816-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recurrence following curative-intent treatment for head and neck squamous cell carcinoma (HNSCC) approaches 50% in locally advanced disease, yet conventional surveillance detects relapse only after anatomical or metabolic thresholds are reached. Minimal residual disease (MRD) monitoring, using circulating tumor DNA (ctDNA) and viral DNA biomarkers, offers an earlier, molecularly informed framework for post-treatment surveillance. This structured narrative review synthesizes contemporary evidence on MRD in HNSCC, drawing on a search of PubMed and Scopus covering January 2020 to March 2026, and defines its role as a clinical instrument for risk-adapted surveillance and decision-making.</p><p><strong>Recent findings: </strong>Across prospective cohorts and platform-validation studies, MRD positivity is independently associated with recurrence risk, with hazard ratios ranging from 3- to tenfold across tumor-informed ctDNA platforms, and molecular relapse frequently precedes radiologic detection by months. Viral DNA assays demonstrate specificities exceeding 95% in virally mediated subtypes. Early interventional data suggest potential for MRD-guided treatment adaptation, but results have been mixed: a recent HPV ctDNA-guided de-escalation trial closed early due to an unacceptable recurrence rate, underscoring that standardized thresholds, optimal testing intervals, and definitive evidence of clinical utility remain unresolved. MRD should currently be integrated as an adjunct to established surveillance modalities rather than a standalone trigger for intervention. Results are best interpreted longitudinally, and an early post-treatment molecular checkpoint at 2-6 weeks represents a high-yield decision point where confirmed positivity may justify intensified evaluation and multidisciplinary review.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":"28 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Management of Desmoid Tumors.","authors":"Gina P Landinez, Shakthi Kumaran Ramasamy, Xiao Wu, Kiyon Naser-Tavakolian, Abin Sajan, Areeb Siddiqui, John Moody, Kirema Garcia-Reyes, Junaid Raja, Venkatesh P Krishnasamy","doi":"10.1007/s11912-026-01821-3","DOIUrl":"10.1007/s11912-026-01821-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide a comprehensive review of percutaneous image-guided techniques in the management of desmoid tumors including evolving thermal and non-thermal ablation options, as well as trans-arterial catheter options. Beyond each treatment modality, we aim to highlight considerations related to patient selection, technical components, and the growing interplay between percutaneous therapies and emerging systemic therapies.</p><p><strong>Recent findings: </strong>Percutaneous ablation, particularly cryoablation, has emerged as a safe and effective treatment for extra-abdominal desmoid tumors, with prospective data demonstrating durable disease control and significant improvements in pain and functional status. A meta-analysis of 694 desmoid tumors treated with thermal ablation reported pooled local control of 88%, symptom relief in 90% of patients, and major complication rates below 5%. Transarterial doxorubicin-eluting embolization has shown promise in both adult and pediatric settings, while bland particle and radioembolic approaches remain under investigation. Irreversible electroporation is emerging as a non-thermal alternative near critical structures. The National Comprehensive Cancer Network (NCCN) Soft Tissue Sarcoma Guidelines now formally incorporate cryoablation along with embolization into the treatment algorithm for progressive, morbid, or symptomatic extra-abdominal desmoid tumors, marking a significant milestone in the recognition of percutaneous techniques as standard-of-care options. Percutaneous image-guided techniques now offer local tumor control with rates similar to surgical resection and a favorable safety profile. Some of these percutaneous techniques are endorsed alongside systemic therapy and radiation as primary options for progressive or symptomatic extra-abdominal desmoid tumors per various guidelines. An important consideration involves the level of data, comprised predominantly of retrospective data, without direct comparative date. The ongoing prospective CRYODESMO-02 trial will help define optimal sequencing and strengthen the evidence base underpinning guideline recommendations.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":"28 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Omega-3 Polyunsaturated Fatty Acids in Modulating Inflammation and Breast Cancer: A Systematic Review of In Vitro, Animal, and Human Studies.","authors":"Rahbika Ashraf, Connor D C Buchanan, Jennifer M Monk, Lindsay E Robinson, David W L Ma","doi":"10.1007/s11912-026-01820-4","DOIUrl":"10.1007/s11912-026-01820-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Inflammation is a hallmark of breast cancer (BC), influencing the tumor microenvironment (TME), immune evasion and tumor growth. N-3 polyunsaturated fatty acids (PUFA), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have anti-inflammatory and immunomodulatory effects, potentially mediated through anti-inflammatory and immune pathways. Evidence is varied by study design, dosage, and formulations, making it difficult to identify consistent mechanisms and therapeutic potential. Therefore, this systematic review aims to provide a comprehensive assessment of the biological and mechanistic effects of n-3 PUFA on inflammation in BC.</p><p><strong>Methods: </strong>A systematic search was conducted on PubMed, Web of Science, and the GOED (Global Organization for EPA and DHA) Clinical Study Database to identify preclinical and clinical studies investigating the effects of n-3 PUFA on inflammation and immune function in BC. Eligible studies were selected using predefined inclusion criteria (PROSPERO CRD42024499082) and assessed for risk of bias using Cochrane Handbook guidance. Primary outcomes included changes in cytokines, tumor-infiltrating immune cells, and inflammatory signaling pathways.</p><p><strong>Results: </strong>Of the 860 articles screened, 67 met the inclusion criteria. Across study types, n-3 PUFA demonstrated significant anti-inflammatory and anti-tumoral effects. Clinical studies showed IL-6 levels decreased by 50-70% with n-3 PUFA treatment. Preclinical studies reported significant reductions in proinflammatory cytokines (IL-6, TNF-α, CCL2/MCP-1), alongside increases in non-inflammatory cytokines (IL-10, IL-2) and a 57-90% reduction in lipid mediators (PGE₂) and associated enzymes (COX-2) with n-3 PUFA treatment. In vitro findings showed large decreases (-40-80%) in NF-κB and matrix metalloproteinase (MMP-2, -9) activity with n-3 PUFA treatment. Variability in n-3 PUFA dose, form, and outcomes was noted across studies.</p><p><strong>Conclusions: </strong>n-3 PUFA exhibit anti-inflammatory and immunomodulatory effects in BC, highlighting their potential as adjuvant therapies to modulate the TME. Standardized research methodologies and clinical trials are needed to clarify dose-response relationships and therapeutic applications.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":"28 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Monitoring for Patients Undergoing Treatment With MEK Inhibitor Monotherapy.","authors":"Jondavid Menteer, Devorah Segal, Stefania Maraka, Laura J Klesse, Prakash Ambady, Michael G Fradley","doi":"10.1007/s11912-026-01814-2","DOIUrl":"10.1007/s11912-026-01814-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Aberrant activation of the RAS-RAF-MEK-ERK signaling pathway contributes to numerous malignancies, congenital syndromes, and cardiovascular disorders, establishing MEK inhibitors (MEKi) as crucial therapeutic agents. MEKi demonstrate substantial clinical benefit as monotherapy (e.g., NF1-associated tumors) or combination therapy (e.g., melanoma, glioma, congenital RASopathies). Cardiovascular adverse events, primarily asymptomatic reductions in left ventricular ejection fraction (LVEF), have prompted intensive echocardiographic monitoring.</p><p><strong>Recent findings: </strong>Emerging evidence indicates that isolated mild LVEF decreases rarely progress to symptomatic heart failure, raising concerns about unnecessary treatment interruptions driven by overly rigorous imaging protocols. Integrating cardiac biomarkers into monitoring strategies could offer a more pragmatic approach, guiding echocardiographic evaluations based on biomarker elevation or symptoms. Expert recommendations advocate personalized, risk-adapted surveillance frameworks. High-risk patients include those with baseline cardiovascular conditions, abnormal biomarker profiles, or significant clinical symptoms. Normal-risk patients can be safely monitored clinically, reserving imaging for biomarker changes or symptom onset. Prospective studies should seek to validate these recommendations.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":"28 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodontitis as a Modulator of Malignant Transformation in Oral Potentially Malignant Disorders: A Narrative Review of Biological Mechanisms and Clinical Implications.","authors":"Giorgia Pieretto, Martina Sansavini, Arthur Rodriguez Gonzalez Cortes, Christian Bacci","doi":"10.1007/s11912-026-01817-z","DOIUrl":"10.1007/s11912-026-01817-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Oral potentially malignant disorders (OPMDs) comprise a heterogeneous group of lesions with a variable risk of progression to oral squamous cell carcinoma (OSCC). Although conventional risk assessment relies primarily on clinical and histopathological features, increasing evidence suggests that the local oral microenvironment may also influence malignant transformation. This narrative review examines the potential role of periodontitis as a modulator of OPMD progression, with particular emphasis on the underlying biological mechanisms and clinical implications. A targeted literature search was conducted in PubMed/MEDLINE, Scopus/EMBASE, and Web of Science for studies published between January 2000 and March 2026.</p><p><strong>Recent findings: </strong>Available evidence suggests that periodontitis may promote a pro-tumorigenic oral microenvironment through the interconnected effects of chronic inflammation, microbial dysbiosis, and metabolic alterations. These processes may enhance epithelial proliferation, genomic instability, immune evasion, and field cancerization, potentially facilitating the progression of OPMDs to OSCC. Although direct longitudinal and interventional evidence remains limited, converging mechanistic, biological, and epidemiological findings support the hypothesis that periodontal disease may contribute to early oral carcinogenic processes. Periodontitis may represent an underrecognized component of oral cancer risk, particularly in patients with OPMDs. Incorporating periodontal assessment into their clinical management may support more comprehensive risk stratification. Although causality has not been established, controlling periodontal inflammation and dysbiosis may offer a potential preventive strategy. Further longitudinal and interventional studies are required to determine the clinical relevance of this association.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":"28 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Onset Colorectal Cancer: From Epidemiologic Shift to Life-Course Carcinogenesis and Age-Attuned Care.","authors":"Magda Grześkiewicz-Szostak, Katarzyna Gęca, Magdalena Skórzewska","doi":"10.1007/s11912-026-01815-1","DOIUrl":"https://doi.org/10.1007/s11912-026-01815-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Early-onset colorectal cancer (EOCRC), conventionally defined as colorectal cancer diagnosed before the age of 50 years, has become one of the most important and unsettling epidemiologic shifts in gastrointestinal oncology. This review critically synthesizes recent evidence on EOCRC epidemiology, risk architecture, life-course carcinogenesis, molecular and microbiome-associated mechanisms, diagnostic delay, screening limitations, treatment considerations, and survivorship needs, with the aim of reframing EOCRC as an age-attuned clinical and biological challenge rather than a simple early presentation of conventional colorectal cancer.</p><p><strong>Recent findings: </strong>Recent population-based analyses confirm that EOCRC incidence is increasing across multiple countries and birth cohorts, with a disproportionate contribution of distal colon and rectal cancers. These data suggest that the rise of EOCRC is unlikely to be explained by improved detection alone and instead points toward changing generational exposures. Contemporary studies have moved the field beyond hereditary predisposition as the dominant explanatory model: although germline syndromes remain essential to identify, most EOCRC is sporadic or incompletely explained by known inherited risk. Recent literature increasingly implicates metabolic dysfunction, obesity, westernized dietary patterns, early-life exposures, inflammation, antibiotic-associated microbial disruption, and host-microbiome disequilibrium. Particularly important are emerging genomic data linking colibactin-associated mutational signatures to younger-onset disease, supporting the hypothesis that microbial genotoxicity may imprint early driver events long before clinical diagnosis. In parallel, recent clinical studies show that EOCRC is frequently symptomatic, yet diagnosis is commonly delayed because alarm features such as rectal bleeding, abdominal pain, altered bowel habits, and anaemia are often underestimated in younger adults. EOCRC is best understood as a heterogeneous, life-course disease shaped by the convergence of inherited susceptibility, environmental and metabolic exposures, microbiome-mediated biology, tumour site, diagnostic-system factors, and survivorship context. Lowering the average-risk screening age to 45 years is necessary but insufficient, because many cases still occur below routine screening thresholds. A modern EOCRC strategy must therefore combine risk-adapted prevention, improved family-history capture, timely investigation of red-flag symptoms, systematic germline and tumour profiling, and treatment planning that accounts for decades of survivorship. Future progress will depend on moving beyond age alone toward integrated models that connect epidemiology, exposome biology, microbial mutagenesis, precision early detection, and age-specific care.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":"28 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}