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CRC incidence increasing in young adults
The incidence of colorectal cancer is increasing among the young adult population while decreasing among adults in the screened population, according to new research data.
“CRC incidence has been declining over the past 40 years due to advances in screening for pre-malignant polyps,” Jason A. Zell, DO, MPH, from the division of hematology/oncology, department of medicine, University of California, Irvine, told Healio Gastroenterology. “In our population-based study, despite the expected decreasing CRC incidence rates among those in the ‘screened population’ (age 50+), we observed that the incidence of CRC is rising in young adults (age 20-29, and 30-39). In fact, CRC incidence is rising in all ages under 50 in California.”
Jason A. Zell
Aiming to assess CRC incidence in young adults aged 20 to 39 years and to identify subgroups with higher risk, Zell and colleagues extracted data from the California Cancer Registry. They analyzed 231,544 incident CRC cases diagnosed from 1988-2009, of which 5,617 occurred in young adults. They stratified incidence rates by age, major race/ethnicity population (71% Caucasian, 7% African American, 12% Hispanic and 10% Asian/Pacific Islander), gender and tumor location, and calculated biannual percent change (BAPC) in CRC incidence throughout the study period.
They found that average annual incidence rates per 100,000 patients was low among young adults, ranging from 0.7 (95% CI, 0.6-0.9) in Hispanic and 0.7 (95% CI, 0.5-1) in African American females aged 20 to 29 years up to 5 (95% CI, 4.5-5.5) in Asian/Pacific Islander males aged 30 to 39 years.
However, despite low CRC incidence, incidence rates increased over time in both young adult males and females yet decreased in both males and females in all age groups ≥50 years. This trend was especially significant for distal colon cancer and rectal cancer in Hispanic females aged 20 to 29 years (BAPC=15.9%; P=.042 and BAPC=10.5%; P=.028, respectively), for distal colon cancer in Hispanic males aged 30 to 39 years (BAPC=10.4%; P<.001) and for rectal cancer in Caucasian males aged 20 to 29 (BAPC=9.4%; P=.006).
“As might be expected in an ‘unscreened’ population, young adults were more likely to have advanced stage at diagnosis, which is important as stage at diagnosis is well known to be strongly associated with survival,” Zell said. “We hope this new report, which is supported by research done by other investigators, will raise awareness about the changing epidemiology of CRC. Further research is needed to determine how patients with young-onset CRC differ from young people without CRC.” — by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.