Key Takeaways
WASHINGTON (September 25, 2026) — Metastatic colorectal cancer (mCRC) continues to increase in patients aged 45 years or younger, and their longer survival and different disease patterns compared with older patients may warrant more aggressive scrutiny of gastrointestinal symptoms, according to new study findings.
The research will be presented at the American College of Surgeons (ACS) Clinical Congress 2026 in Washington, Sept. 26-29, where thousands of surgeons will convene to advance surgical quality, patient safety, and access to care.
“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 aged 45 years and 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 those 45 years and older.
“That’s valuable data to share with patients who are building families, planning for college, and getting married - all of these important life events,” Dr. 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 the younger patients were more often female, of Black or Asian descent, and more likely to live in metropolitan areas. The nature of their cancer also differed notably from their older counterparts, Dr. 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 demonstrated a pattern toward a higher incidence of N2 disease (disease that has spread to four or more lymph nodes) in younger patients, although the study was not powered to compare the two cohorts. “It was interesting that both chemoradiation and advanced disease were more common in the younger population,” Dr. Green said.
Based on her clinical experience, Dr. Lo said it seems younger patients with mCRC tend to have more advanced disease when they are first diagnosed compared with older patients. Younger patients who otherwise feel healthy may downplay their 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,” Dr. Lo added.
Disclosures: Authors have no disclosures to report.
Citation : 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 . Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2026.
Note: Research abstracts presented at the ACS Clinical Congress Scientific Forum are reviewed and selected by a program committee but are not yet peer reviewed.
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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has approximately 95,000 members and is the largest organization of surgeons in the world. "FACS" designates that a surgeon is a Fellow of the American College of Surgeons.
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Young Patients with Metastatic Colorectal Cancer Experience Longer Disease-Specific Survival than the Typical Population Despite Advanced Disease: A SEER Database Analysis
25-Sep-2026
Disclosures: Authors have no disclosures to report.