Evelyn Y. Wong, MD, is a Consultant Medical Oncologist of Gastrointestinal Cancer at the National Cancer Centre Singapore.

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In today’s episode, we had the pleasure of speaking with Evelyn Y. Wong, MD, about the growing challenge of early-onset colorectal cancer (CRC) and the insights from a recent cohort analysis conducted in Singapore. Dr Wong is a consultant medical oncologist specializing in gastrointestinal cancers at the National Cancer Centre Singapore.

In our exclusive interview, Wong discussed the rationale for investigating early-onset CRC, emphasizing the rising incidence worldwide and the need to better understand whether unique molecular or survival patterns distinguish these patients from those with late-onset disease. She reviewed data from approximately 2500 patients in a consented Singaporean cohort, highlighting that molecular characteristics were largely consistent across age groups, but survival outcomes appeared more favorable in younger patients, potentially due to their ability to tolerate more intensive therapies.

Additionally, Wong underscored the importance of multicenter and international collaborations to strengthen these findings and advance prospective studies that can more precisely connect molecular features with environmental exposures and epidemiologic drivers. She also emphasized the role of increasing awareness among clinicians, researchers, pharmaceutical partners, and patient advocates to ensure that the unique needs of younger patients with CRC are addressed within the broader oncology community.

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Podcasts

Dr Wong discusses the growing challenge of early-onset colorectal cancer and the insights from a recent cohort analysis conducted in Singapore. 

Cohort Analysis Shows Importance of Early-Onset CRC Awareness and Investigation: With Evelyn Y. Wong, MD

Dr Wong on Next Steps for Validating the Predictive Utility of Molecular Characteristics in CRC 

“One of the things I feel that we can do to better [validate the predictive utility of] molecular characteristics [in CRC] is have multicenter collaboration. [Our study] was limited because we are just 1 institution; although we [enrolled] 2379 patients, which is a good number, it would always be better to have collaborative efforts in and outside of Asia.”

Evelyn Y.T. Wong, MD, of the Division of Medical Oncology at the National Cancer Centre Singapore, discussed the potential use of molecular characteristics to predict survival outcomes in patients with early-onset colorectal cancer (CRC).

2025 ESMO Gastrointestinal Cancers Congress

, Wong presented data from a single-center retrospective analysis of survival outcomes and molecular characteristics of patients with early-onset CRC (n = 2379). Results showed that patients with early-onset disease experienced a longer median overall survival (OS) vs those with late-onset disease, at 34.6 months vs 28.8 months, respectively (HR, 0.82; 95% CI, 0.66-1.02; 

 = .075). Additionally, patients with early-onset disease had a lower rate of APC mutations compared with those with late-onset CRC, at 32.4% vs 42.2%, respectively. There were no significant differences between the 2 groups in terms of 

 (6.9% vs 4.8%) mutations, or regarding mismatch repair deficiency (4.9% vs 1.9%).

Wong noted that multicenter collaboration is needed in the future to further validate these findings. Although the retrospective study enrolled a significant number of patients, it was still limited by its multicenter design. Accordingly, collaborative efforts are needed within Asia and around the world to further elucidate how disease characteristics affect survival and other outcomes, she added.

Investigators are also interested in exploring the relationship between molecular characteristics of disease and exposure to potential disease-causing factors in early childhood, Wong explained. This type of research cannot be done retrospectively and will require prospective evaluation, she added. Academic centers are already discussing this type of research and multiple groups are beginning to design studies, she said.

Videos

Evelyn Y.T. Wong, MD, discusses discussed the potential use of molecular characteristics to predict survival outcomes in early-onset CRC.

Rising Early‑Onset Colorectal Cancer Rates in Asia Underscore Global Trend in Incidence and Need for Coordinated Research Efforts

“It’s important to [note] that [early-onset CRC is] not just a rising epidemiological trend in the United States, but it’s also similarly seen in many other countries in Southeast Asia.”

Evelyn Y.T. Wong, MD, of the Division of Medical Oncology at the National Cancer Centre Singapore, discussed the survival outcomes and molecular characteristics of patients with early-onset colorectal cancer (CRC) from a large, multiracial cohort in Singapore. 

The retrospective analysis evaluated data from 2379 consented patients, assessing clinical outcomes alongside tumor molecular profiles to better characterize this distinct patient population. Findings from the study, presented on the international stage, highlighted that early-onset CRC represents a growing global health concern, with incidence trends in Asia and Southeast Asia mirroring the rising rates previously reported in the United States. Wong emphasized that these data reinforce the need for broader, multi-institutional collaboration to expand patient representation and to facilitate the conduct of prospective studies. Such efforts would be critical to refine understanding of early-onset CRC biology, treatment response, and long-term survival outcomes.

Wong noted that current investigations in early-onset CRC are focused on key epidemiologic and translational questions, including the reasons underlying the rising incidence of this disease in younger adults, the relationship between epidemiologic trends and molecular tumor features, and whether specific therapeutic strategies should be developed for this subgroup. She underscored that most available treatment paradigms are derived from trials in older patients, and that clinical trial designs dedicated exclusively to patients with early-onset CRC are warranted.

The analysis further underscored the importance of raising awareness of early-onset CRC among clinicians, researchers, pharmaceutical companies, and patient advocacy organizations. Wong explained that in clinical practice, younger patients often seek connections with peers who share similar life-stage and psychosocial challenges, making tailored patient support resources an important component of comprehensive care.

By presenting these findings internationally, Wong aimed to broaden recognition of early-onset CRC as a critical research and public health priority. She stressed that global, coordinated efforts integrating epidemiologic, molecular, and clinical data will be essential to advance the field’s understanding of the disease and inform treatment optimization.

Wong concluded that future research must be prospective, multinational, and collaborative to adequately address the unique needs of younger patients with CRC and guide both therapeutic innovation and policy development in this growing patient population.

Evelyn Y.T. Wong, MD, discusses survival outcomes and molecular characteristics of patients with early-onset colorectal cancer from a cohort in Singapore.

Evelyn Y.T. Wong, MD

Articles

Cohort Analysis Shows Importance of Early-Onset CRC Awareness and Investigation: With Evelyn Y. Wong, MD

Dr Wong on Next Steps for Validating the Predictive Utility of Molecular Characteristics in CRC

Dr Wong on Survival Outcomes and Molecular Characteristics of Patients with Early-Onset CRC