Rising incidence of advanced stage CRC in younger adults supports screening at age 45
Click Here to Manage Email Alerts
Key takeaways:
- As of 2020, incidence rates of regional and distant adenocarcinoma increased to 13.4 and 9, respectively, per 100,000 patients aged 46 to 49 years.
- Regional adenocarcinoma rates remained highest of all stages.
Incidence rates of distant and regional stage colorectal adenocarcinoma have increased over the past two decades among those aged 46 to 49 years and should be considered when counseling patients on screening initiation, research showed.
“This study was performed in the backdrop of recent colorectal cancer screening guideline updates,” Eric M. Montminy, MD, of the division of gastroenterology at John H. Stroger Jr. Hospital of Cook County, told Healio. “Two national organizations are recommending screening initiation at two different ages: USPSTF recommends initiation at age 45 and the American College of Physicians (ACP) recommends initiation at age 50.”
Montminy continued: “Prior confusion has been documented when breast cancer screening recommendations were being changed as well. Our focus was to examine colorectal adenocarcinoma incidence rates with stage stratification of those who are between the ACP and USPSTF recommendations, ages 46 to 49.”
Using Surveillance, Epidemiology and End Results registry data, Montminy and colleagues conducted a cross-sectional analysis of colorectal adenocarcinoma staging incidence among patients aged 46 to 49 years from 2000 to 2020.
According to results published in JAMA Network Open, there were 26,887 diagnoses (54.5% men, 45.5% women) during that time, most of which were among white patients (74.7%), followed by Black (13.6%) and Asian (9.9%) patients.
As of 2020, the incidence rate of localized adenocarcinoma decreased to 7.7 per 100,000 patients, while incidence rates of regional and distant adenocarcinoma increased to 13.4 and 9, respectively, per 100,000 patients. The incidence rate of regional adenocarcinoma “remained the highest” compared with other stages from 2000 to 2020.
With regard to annual percentage change (APC), the incidence rate of distant adenocarcinoma “increased faster than other stages” (APC = 2.2; 95% CI, 1.8-2.6), although researchers also reported a significant increase in regional adenocarcinoma (APC = 1.3; 95% CI, 0.8-1.7). Incidence rates of localized adenocarcinoma decreased during the study period (APC = –0.6; 95% CI, –1 to –0.2).
“Regional and distant stage colorectal cancer in those between the two national screening recommendations are presenting with cancer that typically requires more invasive treatment beyond curative endoscopic management,” Montminy said. “These findings should be taken into consideration when providers are counseling patients on when to initiate colorectal cancer screening.”
He continued: “When combining regional and distant stage colorectal cancer incidence together in only age 46 to 49, the incidence is nearly double the amount of all pancreatic cancer in all ages/stages combined over similar years. This is a concerning findings given that pancreatic cancer is the next most common gastrointestinal cancer in the U.S.”
Collapse
Read more about
Click Here to Manage Email Alerts