Research Feature: Capturing EAO CRC Signs and Symptoms


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Fight Colorectal Cancer’s (Fight CRC) Early-Age Onset Research Workgroup is taking action to understand why rates of colorectal cancer are increasing rapidly among patients under age 50

Beginning in 2019, Fight CRC convened a group of global experts, including researchers, clinicians, and patient advocates to work together in the effort to understand the causes of Early Age-Onset Colorectal Cancer (EAO CRC) and improve care for EAO CRC patients.

Fight CRC EAO CRC Workgroup member, Joshua Demb, PhD, MPH, is a Postdoctoral Scholar at the University of California San Diego. Currently, he is leading a project with members of the EAO CRC Workgroup to better understand the signs and symptoms specifically associated with EAO CRC in hopes of reducing delayed diagnoses and misdiagnoses. 

Tell us about the EAO signs and symptoms systematic review. How can this project advance EAO CRC research?

We are very excited about this collaborative effort supported by Fight CRC. We started this project to understand more about the large percentage of early-age onset colorectal cancer (EAO CRC) cases who present with concerning signs or symptoms for CRC at the time of diagnosis. We decided to use a systematic review to examine three key questions relating to presentation of signs and symptoms that could potentially indicate onset of EAO CRC. A systematic review uses clearly defined questions to identify and analyze all relevant studies that fit the specific criteria. The questions for this systematic review are as follows:

  1. Among adults diagnosed with EAO CRC, what are the most common presenting signs/symptoms preceding and at diagnosis?
  2. Among young adults, how closely associated is the presence of  signs/symptoms and risk of being diagnosed with EAO CRC?
  3. Among individuals diagnosed with EAO CRC who had signs/symptoms present at diagnosis, what is the average length of time from when signs/symptoms begin to receive a diagnosis and its relative impact (if any) on EAO CRC outcomes, such as stage at diagnosis? 

The findings from this project can provide data to help optimize timely diagnosis of EAO CRC. It is important to make sure that we are quickly diagnosing those who have developed signs and symptoms for CRC to maximize the potential effectiveness of treatment and avoid worse long-term outcomes.

What progress has been made to date on the project?

Over the last few months, we completed our literature search to identify all of the potentially relevant articles for inclusion in our study. To ensure that we are prepared for the lengthy literature review process, we are refining our materials and conducting a pilot of the literature search to test our materials, measuring how long reviewing a selection of articles takes and estimating how many team members we will need to support the review process. 

What are the next steps for the systematic review?

Once we get through all phases of the literature review, which we anticipate will take several months, we plan to extract the relevant data for each one of the key questions mentioned above and begin to analyze the data. After completing our analyses, we will write up our findings. 

I am very excited about the progress we have made up to this point, and am looking forward to reaching these next milestones in due time. The entire process of a systematic review takes quite a long time and I am grateful for the enthusiasm and feedback from all of our collaborators throughout this project. 

What is one takeaway you would like the patient community to know?

One of the reasons we embarked on this research was the concern that patients presenting with signs and symptoms for EAO CRC might not be getting timely diagnoses. We hope to leverage the significant number of studies about EAO CRC to learn about the burden and experience of those individuals who had signs or symptoms when diagnosed with EAO CRC. The findings from this review could clarify the current evidence and guide our future research projects to ensure that we are addressing the most pressing issues in EAO CRC.

If you or a loved one, no matter the age, are experiencing signs or symptoms of colorectal cancer, such as blood in the stool, unexplained weight loss, or abdominal pain, it’s essential that you have a conversation with your provider and advocate for your own health!

Interested in learning more about Fight CRC’s research efforts? 

  • Follow Fight CRC on social media and sign up to join our mailing list for more information about our research projects.
  • Join the Fight CRC EAO CRC Workgroup and other researchers, clinicians, and patient advocates across the globe on June 24 and 25 for an interactive Rally on Research focused on EAO CRC. Registration is FREE! 

EAO CRC Workgroup members will be providing an update on their projects including the signs and symptoms systematic review, and we’ll be helping answer burning questions, such as: 

  • What research is underway now? 
  • What’s the path moving forward? 
  • How can clinicians provide great care? 
  • How can patients share their experiences to influence future plans? 
  • How can you join the international research efforts and be part of the community tackling this issue?

One thought on “Research Feature: Capturing EAO CRC Signs and Symptoms

  1. Dear Fight CRC,

    I attended your Rally on Research: Early-Age Onset Colorectal Cancer earlier this year which I found very stimulating and extremely interesting.

    I am just about to start a PhD study in the UK looking at factors that cause delay to diagnosis for patients with EAOCRC. As such I expressed an interest to get involved in the dissemination of the systematic review presented by Joshua Demb and Caitlan Murphy from the EAO CRC Workgroup (chaired by Elsa Weltzien) on EAOCRC Signs & Symptoms, as a UK heath care professional involved in this area of practice and research. Dr.Demb and Dr.Murphy asked for expressions of interest at the time. I am therefore just enquiring if interest in the project is still being sought as I haven’t as yet heard anything back. This is fine as you may have had many experts interested in participating. However I am very keen to contribute to and support any international projects that are addressing EAOCRC and I can support UK and European dissemination if this is still required.

    I would be very interested in hearing from you either way and am eager to get involved in any way that is helpful.

    Many thanks for your time,

    Kind regards,

    Harriet Watson RN, MSc
    Consultant Nurse / Clinical Endoscopist / NIHR Clinical Academic Fellow (KCL)
    Colorectal Surgical Department
    Guys & St. Thomas’ NHS Foundation Trust
    St.Thomas Hospital
    Westminster Bridge Road
    SE1 7EH

    Tel: 020 7188 6475 (secretary direct line)
    Email: or / Twitter: @Watson13Harriet ;

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