Background Based on the current data, colorectal adenocarcinoma is consistently the third most common cancer after breast and lung cancer. Particularly in the special age group, during the last decade, the incidence of early-onset colorectal cancer has increased, and most of them came to the referral hospital as a locally advanced or advanced stage with distant metastasis already. We will report the incidence of this cancer in a specific age group.

Methods This is a retrospective study that has been conducted in the Surgery Department of Moewardi General Hospital Indonesia from January until December 2023. We will evaluate and report the incidence of colorectal cancer with histopathology results of adenocarcinoma, particularly in the early age group. Emergency cases will be included in this study, and the type of resection will also be reported.

Results During 12 months of evaluation, we reported 85 new cases of colorectal adenocarcinoma; 37 cases were early-onset colorectal cancer. 22 cases were rectal cancer and the rest are ascending colon and sigmoid colon cancer. All of them are locally advanced stage, intestinal obstruction is the most common emergency case, were reported in 16 cases and both of them need emergency laparotomy and 40% of these emergency cases had permanent ostomy due to the unresectable rectal cancer.

Conclusions Early onset colorectal adenocarcinoma incidence was increasing, and most of them are locally advanced-stage diseases. Multimodality treatment should be applied to achieve better clinical outcomes in these specific age groups. General consideration should be recognized for the long-term follow-up of these cases and for reducing the morbidity of early-onset colorectal cancer.