Metastatic colorectal cancer is more advanced in younger patients than in older ones, but they survive longer

by American College of Surgeons

edited by Sadie Harley, reviewed by Andrew Zinin

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Metastatic colorectal cancer (mCRC) continues to increase among patients 45 and younger. Their longer survival and different disease patterns compared with older patients may warrant closer scrutiny of gastrointestinal symptoms, according to new study findings.

The research was presented at the American College of Surgeons (ACS) Clinical Congress 2026 in Washington, Sept. 26–29.

"Unfortunately, our study shows that 10-year survival remains quite grim for younger patients, which was the most important thing we learned," said study co-author Winifred M. Lo, MD, FACS, assistant professor of general surgery at Virginia Health Sciences at Old Dominion University in Norfolk.

The retrospective cohort study used the Surveillance, Epidemiology and End Results (SEER) Program database from 2004 to 2024. It included 50,802 patients with metastatic colorectal cancer (mCRC), 4,256 (8.4%) of whom were 45 or younger. Younger patients had longer median disease-specific survival (32 months vs. 22 months) and a higher rate of 10-year survival (17.8% vs. 11.4%) than older patients.

"That's valuable data to share with patients who are building families, planning for college and getting married—all of these important life events," Lo said. "It's important to know what the average patient might face, even if the answer is terrible."

The study focused on mCRC in younger patients because few studies have done so, according to co-author Mary Green, DO, a resident physician at Virginia Health Sciences. "We wanted to know whether the patterns we see in older patients still hold in younger ones, and to look at other prognostic factors for anything new we could learn, given the increase in colorectal cancer," she said.

She noted that the younger patients were more likely to be female or of Black or Asian descent and to live in metropolitan areas. Their cancer also differed notably from that of older patients, Green said. They more frequently had tumors in the left-sided colon (47.8% vs. 39.8%) and rectum (28.4% vs. 18.7%).

The study also showed a pattern toward a higher incidence of N2 disease (disease that has spread to four or more lymph nodes) in younger patients, although it was not powered to compare the two cohorts. "It was interesting that both chemoradiation and advanced disease were more common in the younger population," Green said.

Based on her clinical experience, Lo said younger patients with mCRC seem to have more advanced disease when they are first diagnosed than older patients. Younger patients who otherwise feel healthy may downplay common, nonspecific symptoms of colorectal cancer, and clinicians need to be attuned to that, she noted.

"My big recommendation is for primary care doctors and gastroenterologists. When a patient has nonspecific bloating, rectal pain, bleeding or other unusual GI symptoms you wouldn't expect from everyday living, that person should have a very low threshold for colonoscopy," Lo added.

More information

Green M, Lo WM, et al. Young Patients with Metastatic Colorectal Cancer Experience Longer Disease-Specific Survival than the Typical Population Despite Advanced Disease: A SEER Database Analysis. American College of Surgeons (ACS) Clinical Congress 2026.

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metastatic colorectal cancerColonoscopy

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OncologyGastroenterologyCommon illnesses & Prevention Provided by American College of Surgeons Who's behind this story?

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Citation: Metastatic colorectal cancer is more advanced in younger patients than in older ones, but they survive longer (2026, September 25) retrieved 25 September 2026 from https://medicalxpress.com/news/2026-09-metastatic-colorectal-cancer-advanced-younger.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.