Early-onset colorectal cancer in Argentina: a multicenter surgical analysis of incidence, stage, and metastatic patterns.

Abstract

Early-onset colorectal cancer (EOCRC) is increasing worldwide and now accounts for a growing share of cancer deaths in younger adults. Data from middle- and low-income regions are scarce. We aimed to characterize the incidence, tumor stage distribution, lymph node positivity and metastasis patterns of EOCRC in Argentina. In this retrospective, multicenter cohort study, we analyzed adult patients who underwent colorectal cancer surgery between April 2022 and December 2023. The registry included 1829 patients, of whom 961 were male (52.5%) and 868 were female (47.5%). Mean age was 41.6 years (range 18-49) in the EOCRC group and 68.8 years (range 50-98) in the late-onset colorectal cancer (LOCRC) group. Descriptive statistics were used to summarize patient and tumor characteristics. Comparisons between EOCRC (<50 years) and LOCRC (≥50 years) were performed using χ² tests. Ethnicity data were not available. EOCRC accounted for 15.4% of surgically treated cases, with over two-thirds occurring among individuals aged 40-49 years. Compared with LOCRC, EOCRC patients more frequently presented with advanced tumor stages (T3-T4), higher lymph node positivity, and a greater prevalence of metastases. Tumor location differed between groups, with EOCRC predominating in the rectum and LOCRC showing a right-sided predominance. This national multicenter surgical registry analysis reveals substantial differences in stage and metastatic burden between younger and older colorectal cancer patients in Argentina. The high prevalence of advanced disease among individuals aged 40-49 years supports consideration of earlier initiation of colorectal cancer screening. The Universidad Abierta Interamericana provided partial funding for the publication of this work.