在美国，早发性结直肠癌 (EO-CRC) 的发病率正在上升，并且通常在晚期才被诊断出来。低血清铁蛋白经常在年轻人中偶然发现，然而，EO-CRC 内镜检查的适应证尚不清楚。比较 EO-CRC 患者和健康对照 (HC) 之间的血清铁蛋白，并检查血清铁蛋白与 EO 的关系-具有患者和疾病特异性特征的CRC。从2013年1月1日至2023年12月12日，对50岁以下新诊断的EO-CRC患者进行了回顾性研究。如果在 CRC 组织学诊断后 1 年内测量血清铁蛋白，则患者被纳入。为了补充分析，确定了一组符合类似纳入和排除标准的 HC 进行比较。单独进行敏感性分析，仅包括诊断时或诊断前获得的血清铁蛋白患者，以尽量减少混杂风险。在 85 名 EO-CRC 患者（48 名女性）中，中位血清铁蛋白水平为 26 ng/mL（范围 < 1 -2759 纳克/毫升）。与 HC (n = 80211) 相比，29 岁的 EO-CRC 患者血清铁蛋白 < 20 ng/mL (女性 65%，男性 40%) 的比例较高 (女性 32.1%，男性 7.2%) -39 年（分别为 P = 0.002 和 P < 0.00001）。与较晚期疾病相比，IV 期疾病与显着较高的血清铁蛋白相关（P < 0.001）。诊断前或诊断时获得的血清铁蛋白低于诊断后获得的水平。敏感性分析中也证实了类似的结果。严重缺铁可能表明 EO-CRC 风险增加，特别是在早期阶段。进一步研究确定最佳血清铁蛋白阈值以及将血清铁蛋白常规纳入筛查算法对于制定更有效的 EO-CRC 筛查策略至关重要。©作者 2024。百世登出版集团有限公司出版。保留所有权利。

The incidence of early-onset colorectal cancer (EO-CRC) is rising in the United States, and is often diagnosed at advanced stages. Low serum ferritin is often incidentally discovered in young adults, however, the indication for endoscopy in EO-CRC is unclear.To compare serum ferritin between patients with EO-CRC and healthy controls (HCs), and examine the association of serum ferritin in EO-CRC with patient- and disease-specific characteristics.A retrospective study of patients < 50 years with newly-diagnosed EO-CRC was conducted from 1/2013-12/2023. Patients were included if serum ferritin was measured within 2 years prior to 1 year following CRC histologic diagnosis. To supplement the analysis, a cohort of HCs meeting similar inclusion and exclusion criteria were identified for comparison. A sensitivity analysis including only patients with serum ferritin obtained at or before diagnosis was separately performed to minimize risk of confounding.Among 85 patients identified with EO-CRC (48 females), the median serum ferritin level was 26 ng/mL (range < 1-2759 ng/mL). Compared to HCs (n = 80211), there were a higher proportion of individuals with EO-CRC with serum ferritin < 20 ng/mL (female 65%, male 40%) versus HCs (female 32.1%, male 7.2%) age 29-39 years (P = 0.002 and P < 0.00001, respectively). Stage IV disease was associated with significantly higher serum ferritin compared to less advanced stages (P < 0.001). Serum ferritin obtained before or at the time of diagnosis was lower than levels obtained after diagnosis. Similar findings were confirmed in the sensitivity analysis.Severe iron deficiency may indicate an increased risk of EO-CRC, particularly at earlier stages. Further studies defining the optimal serum ferritin threshold and routine incorporation of serum ferritin in screening algorithms is essential to develop more effective screening strategies for EO-CRC.©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.