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August 03, 2019
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Colorectal cancer on the rise among younger Canadians

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Darren Brenner

A recent cohort study identified an increasing incidence of colorectal cancer diagnoses among Canadian men and women younger than 50 years.

“While rates among adults younger than 50 are still considerably lower than older adults, our results suggest that more recent birth cohorts are seeing the highest rates ever recorded in Canada,” Darren R. Brenner, PhD, of the University of Calgary, told Healio Gastroenterology and Liver Disease. “This is in contrast to adults where population-based screening programs are proving effective at reducing the incidence and subsequent mortality from colorectal cancer.”

Researchers used data from the National Cancer Incidence Reporting System (1969-1992) and the Canadian Cancer Registry (1992-2015) to determine the incidence of CRC. They included every Canadian adult diagnosed with CRC since 1969 in the study and compared trends among men and women based on the age categories younger than 50 years and older than 50 years.

Investigators identified 688,515 cases of CRC between 1971 and 2015. While rates among older adults decreased, researchers found that rates among younger men and women increased since 2006 and 2010, respectively. The mean annual percentage change among men younger than 50 years was 3.47% from 2006 and 2015. For women younger than 50 years, the mean annual percentage change was 4.45% since 2010.

Compared with patients in the reference birth cohort of 1936, men in the youngest cohort had more than double the risk for CRC (IRR = 2.57; 95% CI, 1.32–5.02). The incidence rate ratios were not significant among women but increased in successively younger cohorts.

Brenner said additional research is needed to understand the factors impacting this increase.

“Given the short timeframe in which the rates are rising – it is unlikely to be explained by genetic changes in the population,” he said. “Likely culprits include major lifestyle and exposure trends that have changed over the past 40 years, such as excess body weight being observed at younger ages than in previous generations. Other major changes such as diets lower in fiber and higher in processed foods among younger populations may also be contributing. Several research projects are underway to understand at the population exposure level as well as at the cellular level what is driving CRC risk in younger patients.” by Alex Young

Disclosures: The authors report no relevant financial disclosures.