Abstract B010: Building a global research nextwork focusing on etiology for early-onset colorectal cancer (EOCRC): findings from the Fight Colorectal Cancer 2025 Barcelona Think Tank

Abstract The rising incidence of early-onset colorectal cancer (EOCRC), which affects individuals under 50, is becoming a significant public health issue, particularly in high- and middle-income countries but now increase in lower income countries. EOCRC often lacks traditional risk factors like family history or hereditary syndromes and is associated with more aggressive tumors, delayed diagnoses, and considerable psychosocial and financial burdens. Due to fragmented data and a lack of large-scale studies, progress in EOCRC research has been limited. In response, Fight Colorectal Cancer (Fight CRC) organized the first-ever Global Think Tank on EOCRC, held in Barcelona, Spain, in June 2025, with the aim of aggregating global data, identifying emerging risk factors, establishing international research collaborations, and creating a sustained, patient-centered scientific network. The Think Tank utilized a hybrid consensus-development model, incorporating epidemiologic synthesis, data analysis, and stakeholder engagement. The event brought together 71 delegates from 18 countries, representing various fields, including molecular biology, oncology, and patient advocacy. Prior to the meeting, global data was gathered through a 36-item patient survey, which garnered 516 responses from 21 countries, an epidemiologic review of EOCRC incidence and mortality, and expert roundtables discussing potential etiologic factors. The two-day meeting was structured to foster interdisciplinary collaboration, with Day 1 focusing on EOCRC epidemiology and patient integration, and Day 2 addressing emerging hypotheses and regional disparities. New, unpublished data revealed that only 15.2% of EOCRC patients were aware that colorectal cancer could occur before 50, while 42% experienced diagnostic delays, often due to clinicians dismissing symptoms based on age. Furthermore, the incidence of EOCRC is rising by 1.5-4.0% annually, with the highest rates observed in New Zealand, Chile, and Puerto Rico. Over 60% of EOCRC cases are located in the rectum or sigmoid colon, and there were no significant sex-based differences in incidence. Real-time consensus polling indicated strong agreement that low awareness is a major barrier to early detection, with 92% of participants in favor of increasing awareness, and 85% emphasizing the role of diet and processed foods as key environmental factors. Five workgroups were formed, focusing on scientific research, epidemiologic tools, biobanking, global sustainability and advocacy, and risk stratification and awareness. These groups have created a 24-month roadmap that includes launching cohort studies, developing a data-sharing platform, establishing biobanks in underrepresented regions, and aligning global advocacy efforts. The meeting concluded with a commitment to ongoing international collaboration, prioritizing patient voices and ensuring equity, diversity, and inclusion. The momentum generated by this meeting sets the stage for future collaborations aimed at reducing EOCRC incidence and improving outcomes for young patients worldwide. Citation Format: Andrea J. Dwyer, Jose Perea, Daniel Buchanan, Rebecca Siegel, Kiran Ilgan, Anjee Q. Davis, Andrew Chan. Building a global research nextwork focusing on etiology for early-onset colorectal cancer (EOCRC): findings from the Fight Colorectal Cancer 2025 Barcelona Think Tank [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: The Rise in Early-Onset Cancers—Knowledge Gaps and Research Opportunities; 2025 Dec 10-13; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(23_Suppl):Abstract nr B010.