• COLORECTAL CANCER
• INTESTINAL MICROBIOLOGY

The recognition that early-onset colorectal cancer (EO-CRC) rates are rising has sent shockwaves through the field of gastroenterology in recent years. Cases of celebrities affected by EO-CRC have similarly shocked the broader public and have drawn attention to the importance of screening. After television anchor Katie Couric’s husband died of EO-CRC at age 42, she underwent an on-air colonoscopy in 2000, which led to a significant increase in screening colonoscopy rates that was dubbed ‘the Katie Couric effect’.1 More recently, the acclaimed actor Chadwick Boseman tragically died of EO-CRC at age 43, again increasing awareness and discussion of the need for screening. Colonoscopy is an excellent screening tool but of limited utility to individuals younger than the recommended age of initiation of screening, which is 50 in many parts of the world.2 While overall CRC rates have progressively decreased over time due to systematic screening, CRC has alarmingly been on the rise in younger individuals.3 Approximately 12% of CRCs are diagnosed in individuals younger than 50,4 prompting a recent shift of screening recommendations in the …