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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.

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