Clinically Significant Metachronous Colorectal Pathology Detected Among Young-Onset Colorectal Cancer Survivors: Implications for Post-Resection Surveillance Guidelines

The incidence of colorectal cancer (CRC) has been increasing worldwide among young adults aged 18–50 years, and the reason remains unknown.1,2 Patients with sporadic young-onset CRC (YOCRC; diagnosed at 50 years or younger) are postulated to have a more biologically active colorectum prone to malignant transformation earlier in life. Exposure risk factors, such as Western-style diet, obesity, physical inactivity, antibiotic use, and microbiome, overlaid with gene–environment interactions, have been implicated as plausible triggers.