How to manage the patient with early-age-of-onset (<50 years) colorectal cancer?

Colorectal cancer rarely occurs before the age of 50. When it does, it is often advanced and aggressive. There may be predisposing genetic and immune factors that lead to its origin. Genetic counseling is indicated for all patients younger than 50 with colorectal cancer. Before surgery, the tumor and the patient must be evaluated as fully as possible, so that optimal treatment, follow-up, and surveillance are used.