Last July 4th marked a personal milestone for me as I delivered my first international presentation as a patient advocate at ESMO GI 2025 in Barcelona. This opportunity followed my participation in the WECAN Academy and allowed me to represent the growing community affected by early-onset colorectal cancer (EOCRC).

A Concerning Rise in EOCRC

The data on EOCRC is becoming more urgent with each passing year. Since the early 1990s, incidence rates among young adults have been increasing by around 2% annually.¹ Projections indicate that by 2030, colon cancer diagnoses in 20–34-year-olds may increase by 90%, and rectal cancer by 124%.²

Yet the challenges go beyond statistics. Younger patients frequently face delayed diagnoses, often needing to see multiple healthcare professionals before being taken seriously. Many report being dismissed due to their age, only to receive a diagnosis at a more advanced stage.

Sharing the Patient Voice

In my talk, I shared stories from young survivors, including individuals diagnosed as early as 26 years old. A recent survey reveals the extent of the issue: 75% of EOCRC patients saw at least two doctors before receiving a diagnosis, and 20% saw four or more. These delays, often driven by medical bias, can be life-altering.^3,4

Improved awareness among general practitioners, as well as among young adults themselves, is urgently needed. More risk-based prevention and earlier screening must become a reality.

What Young Patients Need

Care for younger people with CRC must be tailored to their specific circumstances. This includes:

• Empathetic, age-appropriate communication from healthcare professionals;
• Multidisciplinary support that addresses fatigue, pain, emotional well-being, sexual health, and fertility concerns;
• Involvement in decision-making about their treatment and care.

It was an honour to present the recent poster from NCT Heidelberg, developed in collaboration with Bruno Christian Köhler, which outlines a patient-informed care programme designed specifically for EOCRC. The project is grounded in the experiences and insights of young people living with this disease.⁵

I was also proud to reference a new publication led by Trishna Bharadia, Jan Geissler and colleagues, which strongly reinforces the value of shared decision-making in cancer care.⁶

Looking Ahead

If we want meaningful change, the coming year must focus on improving equity, personalisation, and true partnership with patients in outcome research. The myth that “you’re too young to have CRC” must be challenged at every level of care and communication.

I’m grateful to the ESMO and European School of Oncology faculty for the invitation to speak, and to all the patients who continue to share their stories so generously. Your voices are shaping a better future.

Together, we are building momentum for change.

Sources:

1. Spaander, Nat Rev Dis Primers, 2023.
2. Medici, Cancers, 2023
3.  Newcomer, K. L., & Porter, L. D. JCO (2021) and
4. Vitaloni M, Maguet K, Carlan A, Stack P, de Jong V, Williams R, Maravic Z, BMC Gastroenterology (2025)
5. Kaunath, K et al. Towards a tailored care program: Exploring the characteristics of EOCRC patients at a comprehensive cancer centre in Germany, ESMOGI 2025
6. Bharadia, T., Geissler, J., Robson, R. et al. Seven Actions Towards Advancing Patient Authorship and Collaboration in Peer-Reviewed Publications. Patient (2025). https://doi.org/10.1007/s40271-025-00750-w

Author:

Michael Kecht