Abstract / Description
BackgroundThe increasing incidence of early-onset colorectal cancer (age 15 mutations per megabase) and non-hypermutated (TMB ≤15 mutations per megabase) groups. We evaluated the TMB difference between EOCRC and LOCRC using gamma regression and compared genomic mutation data between EOCRC and LOCRC using multiple logistic regression and pathway enrichment analysis. The primary study objective was to compare genomic mutational patterns between EOCRC and LOCRC, stratified by TMB groups.FindingsBetween Jan 1 and Dec 31, 2024, 17 133 tumour samples from patients with colorectal cancer in eight countries were analysed (Canada [n=218], China [n=3009], France [n=62], Nigeria [n=64], South Korea [n=44], Spain [n=250], the Netherlands [n=281], and the USA [n=13 205]). Among 17 133 patients, 9452 (55·2%) were male, 7681 (44·8%) were female, 10 174 (59·4%) were White, 3904 (22·8%) were Asian or Pacific Islander, 983 (5·7%) were Black, and 4983 (29·1%) had EOCRC. In hypermutated colorectal cancer, EOCRC exhibited a significantly higher TMB compared with LOCRC (mean ratio 1·11 [95% CI 1·06-1·16]; p