ArticleJournal of the National Cancer Institute2023
Red-flag signs and symptoms for earlier diagnosis of early-onset colorectal cancer.
Article in Journal of the National Cancer Institute, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Shaping the future of early-onset colorectal cancer prevention.Nature reviews. Cancer · 2026Review
- Closing the Diagnostic Gap in Early-Onset Colorectal Cancer: Red-Flag Symptoms, Screening, and Inherited Risk.Cancers · 2026Review
- Positive Predictive Value of Symptoms for Early-Onset Colorectal Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Prognostic and Predictive Role of Circulating Tumor DNA in Locally Advanced Rectal Cancer Managed With Total Neoadjuvant Therapy: A Systematic Review.Health science reports · 2026Review
- Application of Systems Genetics to Investigate Molecular Pathology of Early-Onset Colorectal Cancer.Chemical biology & drug design · 2026Review
- Early and late-onset colorectal cancers: a case-case comparison of risk factors.Cancer causes & control : CCC · 2026Article
- Temporal association of constipation and diarrhoea with a subsequent diagnosis of colorectal cancer: a propensity score-matched case-control study using real-world primary care data.BMJ open gastroenterology · 2026Article
- Metabolic and Laboratory Biomarkers in Early-Onset Versus Late-Onset Colorectal Cancer: A Case-Control Study.Cancers · 2026Article
- State-level burden of early onset colorectal cancer in the US: a Global Burden of Disease study, 1980 to 2021.Proceedings (Baylor University. Medical Center) · 2026Article
- Knowledge, Symptom Awareness, and Referral Practices of Primary Care Providers in Early-Onset Colorectal Cancer.Population health management · 2026Article
- Exploring the link between Mycobacterium avium subsp. Paratuberculosis and colorectal cancer development.BMC gastroenterology · 2026Article
- LncRNA EWSAT1 promotes colorectal cancer progression by regulating the miR-330-5p/CPEB4 axis.American journal of translational research · 2026Article
- When the carcinogenic window opens before the screening window: the age-threshold blind spot in early-onset colorectal cancer.Frontiers in oncology · 2026Article
- Knowledge, Attitudes, and Perceptions Around Colorectal Cancer Screening and Risk Among 20-49 Year Olds.Digestive diseases and sciences · 2025Article
- Addressing conceptual and design gaps in the oncology nutrition evidence base during chemotherapy: contributions of the Exercise and Nutrition Interventions to Improve Cancer Treatment-Related Outcomes Consortium.Journal of the National Cancer Institute · 2025Article
- Understanding TikTok's Role in Young-Onset Colorectal Cancer Awareness and Education.Journal of cancer education : the official journal of the American Association for Cancer Education · 2025Article
- Risk modeling of delayed postoperative bleeding after endoscopic submucosal dissection for early colorectal cancer and precancerous lesions.World journal of gastrointestinal surgery · 2025Article
- Incidence, characteristics, and survival in early- and late-onset colorectal cancer.Acta oncologica (Stockholm, Sweden) · 2025Article
- The Association of Anemia on Non-AIDS-Defining Cancer and Subsequent Survival Among People With HIV After Antiretroviral Initiation.Journal of acquired immune deficiency syndromes (1999) · 2025Article
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPrompt detection of colorectal cancer (CRC) among individuals younger than age 50 years (early-onset CRC) is a clinical priority because of its alarming rise.
methodsWe conducted a matched case-control study of 5075 incident early-onset CRC among US commercial insurance beneficiaries (113 million adults aged 18-64 years) with 2 or more years of continuous enrollment (2006-2015) to identify red-flag signs and symptoms between 3 months to 2 years before the index date among 17 prespecified signs and symptoms. We assessed diagnostic intervals according to the presence of these signs and symptoms before and within 3 months of diagnosis.
resultsBetween 3 months and 2 years before the index date, 4 red-flag signs and symptoms (abdominal pain, rectal bleeding, diarrhea, and iron deficiency anemia) were associated with an increased risk of early-onset CRC, with odds ratios (ORs) ranging from 1.34 to 5.13. Having 1, 2, or at least 3 of these signs and symptoms were associated with a 1.94-fold (95% confidence interval [CI] = 1.76 to 2.14), 3.59-fold (95% CI = 2.89 to 4.44), and 6.52-fold (95% CI = 3.78 to 11.23) risk (Ptrend < .001), respectively, with stronger associations for younger ages (Pinteraction < .001) and rectal cancer (Pheterogenity = .012). The number of different signs and symptoms was predictive of early-onset CRC beginning 18 months before diagnosis. Approximately 19.3% of patients had their first sign or symptom occur between 3 months and 2 years before diagnosis (median diagnostic interval = 8.7 months), and approximately 49.3% had the first sign or symptom within 3 months of diagnosis (median diagnostic interval = 0.53 month).
conclusionsEarly recognition of red-flag signs and symptoms (abdominal pain, rectal bleeding, diarrhea, and iron-deficiency anemia) may improve early detection and timely diagnosis of early-onset CRC.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.