Increasing Incidence of Colorectal Cancer in Young Adults

Background. Colorectal cancer (CRC) incidence and mortality has been declining in the U.S. Despite success in reducing CRC incidence, incidence of early-onset CRC has increased markedly. In this study, we identified age-related disparities in CRC incidence and mortality, and investigated differences in anatomical distribution of colon cancers between populations. Methods. CRC trends were evaluated using Surveillance, Epidemiology, and End Results Program Data from 1980–2016 for individuals under age 50 and 50 years and older. Rates and ratios were calculated using SEER∗Stat. Regression analyses were calculated using Joinpoint. Results. Increased CRC incidence among individuals under age 50 was observed. Among individuals under age 50, incidence-based mortality (IBM) stabilized, while incidence and IBM decreased for individuals aged 50 years and older. Normalized trends indicated increased rectal cancer incidence for individuals under age 50, particularly among individuals aged 30–39. Similar incidence of proximal and distal colon cancers in individuals under age 50 was observed, while colon cancers in individuals aged 50 and older were primarily distal. Conclusions. We found age-related disparities in CRC incidence and IBM between individuals under age 50 and age 50 years and older. Increasing incidence rates of rectal cancer substantially accounts for this disparity among individuals under age 50. The escalating trends of early-onset CRC warrant investigation into the factors leading to the population-level trends.

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Detailed incidence and mortality trends of early-onset colorectal cancer in Canada.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e15539 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e15539-e15539

Author(s):

Dylan E. O'Sullivan ◽

Yibing Ruan ◽

Robert Liam Sutherland ◽

Winson Y. Cheung ◽

Steven J. Heitman ◽

...

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Colon Cancer ◽

Late Stage ◽

Early Onset ◽

Age Group ◽

Incidence And Mortality ◽

Specific Mortality ◽

Cancer Specific Mortality ◽

Early Onset Colorectal Cancer

e15539 Background: There has been a consistent increase in the incidence of early-onset colorectal cancer (eoCRC), under the age of 50, in Canada since the late 1990s. Questions remain surrounding how these trends vary by topography, histology, and stage, and related trends with CRC-specific mortality. Methods: CRC incidence data were obtained from the Canadian Cancer Registry and CRC-specific mortality data from the Canadian Vital Statistics – Death Database for the years 2000 to 2017. Age-specific average annual percent changes (AAPC) in the incidence (by topography and histology) and mortality rates of CRC were estimated using the National Cancer Institute’s Joinpoint Regression Program. To determine age-specific differences (5-year age groups) in CRC diagnosis at late stage (III and IV) for years 2011 to 2017 combined, a logistic regression model adjusting for sex with the 50-54 age group as the referent was conducted. Results: AAPCs and 95% confidence intervals in the rates of incidence (topography and histology) and mortality of eoCRC from 2000 to 2017 in Canada are presented in Table. Different trends in topography were observed across sexes with the largest increases in the distal colon (splenic flexure, descending, and sigmoid) and rectum among males and rectum only among females. Significant increases were observed for non-mucinous adenocarcinomas, while significant decreases were observed for mucinous adenocarcinomas among the 40-49 age group. Compared to the 50-54 age group, only the 45-49 group had a significantly higher odds of developing late-stage colon cancer, while men and adults 25-49 had a higher odds of developing late stage rectal cancer. Despite increases in the incidence of eoCRC there has only been a significant increase in mortality for men aged 20-39. Trends in mortality vary by site, with significant decreases observed for colon cancer-specific mortality among the 40-49 age group and increases in rectal cancer-specific mortality for adults aged 20-49. Conclusions: These results indicate that the largest increases in incidence and mortality for eoCRC have occurred in the rectum and trends have varied by sex. Further research on the etiology and treatment outcomes of eoCRC patients are warranted for this patient population.[Table: see text]

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Colorectal Cancer in Lebanon: Incidence, Temporal Trends, and Comparison to Regional and Western Countries

Cancer Control ◽

10.1177/1073274821996869 ◽

2021 ◽

Vol 28 ◽

pp. 107327482199686

Author(s):

Najla A. Lakkis ◽

Ola El-Kibbi ◽

Mona H. Osman

Keyword(s):

Colorectal Cancer ◽

Cancer Incidence ◽

Temporal Trends ◽

Incidence Rates ◽

Steady Increase ◽

P Value ◽

Western Countries ◽

Incidence And Mortality ◽

Colorectal Cancer Incidence ◽

Males And Females

Global trends in the incidence and mortality rates of colorectal cancer show a steady increase with significant predilection to western developed countries, possibly linking it to westernized lifestyles among other risk factors. This study aims to investigate the incidence and trends of colorectal cancer in Lebanon, a country in the Middle East and North Africa region, and to compare these rates to those in regional and western countries. Colorectal cancer incidence data were extracted from the Lebanese National Cancer Registry for the currently available years 2005 to 2016. The calculated age-standardized incidence rates and age-specific rates were expressed as per 100,000 population. The age-standardized incidence rates of colorectal cancer in Lebanon increased from 16.3 and 13.0 per 100,000 in 2005 to 23.2 and 20.2 per 100,000 in 2016, among males and females, respectively. The incidences were higher for males, and they increased with age. The annual percent change was +4.36% and +4.45%, in males and females respectively (p-value < 0.05). There was a non-statistically significant trend of decrease in recent years (since 2012 in males and since 2011 in females). The age-standardized incidence rates in Lebanon were higher than those in the majority of the regional countries, but lower than the rates in developed western countries. There were high age-specific incidence rates at age groups 40-44 and 45-49 years in Lebanon in both males and females (with significant rising temporal trend) compared to other countries, including the ones reported to have the highest colorectal cancer age-standardized incidence rate worldwide. Therefore, the burden of colorectal cancer is significant in Lebanon. This raises the necessity to develop national strategies tailored to reduce colorectal cancer incidence through promoting healthy lifestyles, raising awareness, and early detection as of 40 years of age.

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Colorectal Cancer in Young and Older Adults in Uruguay: Changes in Recent Incidence and Mortality Trends

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158232 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8232

Author(s):

Carina Musetti ◽

Mariela Garau ◽

Rafael Alonso ◽

Marion Piñeros ◽

Isabelle Soerjomataram ◽

...

Keyword(s):

Colorectal Cancer ◽

Older Adults ◽

Cancer Incidence ◽

Age Groups ◽

Incidence Rates ◽

Mortality Trends ◽

Screening Programs ◽

Lifestyle Risk Factors ◽

Incidence And Mortality ◽

Colorectal Cancer Incidence

Uruguay has the highest colorectal cancer incidence rates in Latin America. Previous studies reported a stable incidence and a slight increase in mortality among males. We aimed to assess colorectal cancer incidence (2002–2017) and mortality trends (1990–2017) by age groups and sex, using data from the National Cancer Registry. Annual percent changes (APCs) were estimated using joinpoint regression models. We included 27,561 colorectal cancer cases and 25,403 deaths. We found an increasing incidence among both males and females aged 40–49, with annual increases of 3.1% (95%CI: 1.21–5.03) and 2.1% (95%CI: 0.49–3.66), respectively, and an increasein the rate in older males (70+) of 0.60% (95%CI: 0.02–1.20) per year between 2002 and 2017. Mortality remained stable among those younger than 50, whereas it decreased for older females aged 50–69 and 70+ (APC: −0.61% (−1.07–0.14) and −0.68% (−1.02–0.34), respectively), and increased for the oldest males (70+; APC: 0.74 (0.47–1.01)). In conclusion, we found rising colorectal cancer incidence accompanied by stable mortality in young adults. Sex disparities were also found among the older adults, with a more favorable pattern for females. Exposures to dietary and lifestyle risk factors, and inequalities in access to and awareness of screening programs, are probably among the main underlying causes and deserve further investigation.

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AGE-RELATED FEATURES OF THE DYNAMICS OF MORBIDITY AND MORTALITY, LOCALIZATION AND HISTOLOGICAL STRUCTURES OF RECTAL CANCER (POPULATION STUDY)

Успехи геронтологии ◽

10.34922/ae.2020.33.5.010 ◽

2021 ◽

pp. 900-907

Author(s):

В. М. Мерабишвили ◽

Д. М. Дубовиченко ◽

М. Ю. Вальков ◽

А. М. Щербаков ◽

Э. Н. Мерабишвили

Keyword(s):

Rectal Cancer ◽

Malignant Tumors ◽

Federal District ◽

Distal Colon ◽

Morbidity And Mortality ◽

The North ◽

Leading Role ◽

Age Related ◽

Icd 10 ◽

North Western

Рак прямой кишки (РПК) - это злокачественная опухоль дистального отдела толстой кишки эпителиального происхождения. Ежегодно в России регистрируется более 30 тыс. (30 969 в 2018 г.) новых случаев РПК и 16 тыс. (16 151) случаев смерти. Индекс достоверности учета (отношение числа умерших к заболевшим) составляет 0,52 %. РПК относится к локализациям со средним уровнем летальности. В Северо-Западном Федеральном округе зарегистрировано более 3 тыс. первичных случаев РПК (3 285 в 2018 г.). Государственная статистика РПК представляет данные о заболеваемости и смертности населения по трем рубрикам МКБ-10 вместе (С19-21). Детальная разработка данных не только отдельно по каждой рубрике МКБ-10, но и по четвертому знаку возможна только по материалам баз данных раковых регистров. Созданный нами Популяционный раковый регистр Северо-Западного Федерального округа насчитывал на 01.01.2019 г. более 1 млн (1 067 661) случаев злокачественных новообразований (ЗНО), в том числе РПК - 50 745 случаев, или 4,8 %. Удельный вес РПК близок к среднероссийскому - 4,9 %. В работе представлена детальная структура онкологической патологии по РПК. Ведущая роль из трех указанных рубрик принадлежит ЗНО прямой кишки (С20) - 75,4 %; 19,8 % приходится на ЗНО ректосигмоидного отдела (С19) и только 4,7 % на С21 - ЗНО ануса и анального канала. По всем этим рубрикам представлена динамика структуры, которая оказалась достаточно устойчивой. Rectal cancer is a malignant tumor of the distal colon of epithelial origin. Every year, more than 30,000 (30 969 - 2018) new cases of Rectal cancer and 16,000 deaths (16 151) are registered in Russia. The index of reliability of accounting (the ratio of the number of dead to sick) is 0,52 %. Rectal cancer refers to localities with an average mortality rate. In the North-Western Federal district, more than 3 thousand primary cases of Rectal cancer were registered (3285 - 2018). The state statistics of the Rectal cancer provides data on morbidity and mortality in three categories of ICD-10 together (C19-21). Detailed development of data not only separately for each category of ICD-10, but also for the fourth sign is possible only from the data bases of cancer registers. As of 01.01.2019, the Population cancer register of the North-Western Federal district created by us totaled more than 1 million cases of malignant tumors (1 067 661), including Rectal cancer - 50 745 cases, or 4,8 %. The share of the Rectal cancer is close to the national average - 4,9 %. The article presents a detailed structure of cancer pathology in Rectal cancer. The leading role of the 3 speciﬁed categories belongs to the rectal malignant tumors (C20) - 75,4 %, 19,8 % falls on the malignant tumors of the rectosigmoid department (C19) and only 4,7 % on the C21 - malignant tumors of the anus and anal canal. For all these categories, the dynamics of the structure is presented, which proved to be quite stable.

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Subsite-Specific Dietary Risk Factors for Colorectal Cancer: A Review of Cohort Studies

Journal of Oncology ◽

10.1155/2013/703854 ◽

2013 ◽

Vol 2013 ◽

pp. 1-14 ◽

Cited By ~ 32

Author(s):

Anette Hjartåker ◽

Bjarte Aagnes ◽

Trude Eid Robsahm ◽

Hilde Langseth ◽

Freddie Bray ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Rectal Cancer ◽

Colon Cancer ◽

Cohort Studies ◽

Distal Colon ◽

Proximal Colon ◽

Risk Estimates ◽

Specific Risk ◽

Dietary Components

Objective. A shift in the total incidence from left- to right-sided colon cancer has been reported and raises the question as to whether lifestyle risk factors are responsible for the changing subsite distribution of colon cancer. The present study provides a review of the subsite-specific risk estimates for the dietary components presently regarded as convincing or probable risk factors for colorectal cancer: red meat, processed meat, fiber, garlic, milk, calcium, and alcohol.Methods. Studies were identified by searching PubMed through October 8, 2012 and by reviewing reference lists. Thirty-two prospective cohort studies are included, and the estimates are compared by sex for each risk factor.Results. For alcohol, there seems to be a stronger association with rectal cancer than with colon cancer, and for meat a somewhat stronger association with distal colon and rectal cancer, relative to proximal colon cancer. For fiber, milk, and calcium, there were only minor differences in relative risk across subsites. No statement could be given regarding garlic. Overall, many of the subsite-specific risk estimates were nonsignificant, irrespective of exposure.Conclusion. For some dietary components the associations with risk of cancer of the rectum and distal colon appear stronger than for proximal colon, but not for all.

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Patients’ Experiences of Colorectal Cancer and Oncology Services in North Queensland

Australian Journal of Primary Health ◽

10.1071/py08041 ◽

2008 ◽

Vol 14 (3) ◽

pp. 93 ◽

Cited By ~ 5

Author(s):

Craig Veitch ◽

Lisa Crossland ◽

Heather Hanks ◽

Yik-Hong Ho ◽

Marlous Steeghs

Keyword(s):

Colorectal Cancer ◽

Metropolitan Areas ◽

Full Range ◽

Signs And Symptoms ◽

Incidence Rates ◽

Postal Survey ◽

Warning Signs ◽

Related Factors ◽

Incidence And Mortality

Colorectal cancer (CRC) accounts for 15% of cancer incidence and mortality in Australia. Incidence rates have been rising for two decades. Little is known about the experiences, attitudes and perceptions of people with CRC who live in non-metropolitan areas. The aim of this study was to investigate participants? experiences with and attitudes to CRC. This Cancer Council of Queensland-funded project collected data in three phases - focus groups, individual interviews, postal survey - from patients treated for CRC in north Queensland. Qualitative and quantitative approaches were used to analyse the data. Participants had very little knowledge of CRC signs and symptoms pre-diagnosis, which sometimes led to delays in diagnosis. The speed of diagnosis was dependent on several practitioner-related factors. Treatment-related issues included coming to grips with the diagnosis and preparedness for treatment and side-effects. Personal beliefs and attitudes influenced treatment and follow-up decisions. Rural participants encountered travel-related difficulties, particularly during treatment as outpatients. There was a strong belief in the need for more public education about CRC in general, warning signs and symptoms, and familial risk factors. Good understanding of people?s knowledge of CRC, their attitudes towards screening, diagnosis, treatment and follow-up, will enable health and cancer services provide focused and relevant support to people with CRC, their families and carers. This is especially important in non-metropolitan areas where the full range of specialist services is not locally available.

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Mutational signatures of early-onset colorectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e15113 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e15113-e15113

Author(s):

Silvia Marsoni ◽

Federica Zanardi ◽

Fabio Iannelli ◽

Elisa Salviato ◽

Francesco Ferrari ◽

...

Keyword(s):

Colorectal Cancer ◽

Correlation Analysis ◽

Early Onset ◽

R Package ◽

Pooled Analysis ◽

Incidence Rates ◽

Mutational Signatures ◽

Relative Contribution ◽

Repair Deficiency ◽

Sporadic Crcs

e15113 Background: Despite a reduction of Colorectal Cancer (CRC) incidence in western countries in the past decades, Early-Onset CRCs (EO-CRC, patients diagnosed with CRC ≤ 40 years old) incidence has increased. Although frequently occurring in the context of familial syndromes, EO-CRCs are mainly sporadic cases and phenotipically enriched for distal localisation and advanced stage at diagnosis. Whether EO-sporadic CRCs pathogenesis differs from that of normal-onset (NO) CRC and how this might impact incidence rates is currently unknown. This had prompted us to ask if, at the genetic level, “traces” of peculiar pathogenic processes could be identified in EO-specific (or -enriched) genetic signatures (GS). Methods: The mutational signatures of 424 TCGA CRC patient samples (19 EO and 405 ≥ 50 years at diagnosis) were analyzed and the similarity between each mutational profile and COSMIC GS was calculated using Bioconductor R package Mutational Patterns (doi: 10.1186/s13073-018-0539-0). Unsupervised hierarchical clustering of the samples according to similarity to GS was performed in single cohort and pooled analysis. Association between age and individual GS was assessed through grouped and linear correlation analysis. Results: EO-CRC patients were grouped in three main clusters: Cluster1 exposing a major similarity with GS10 (associated with defects in polymerase proofreading activity), Cluster2 showing stronger similarities with GS6 (associated with mismatch repair deficiency), and GS1 (associated with 5-MeC deamination) and Cluster3 presenting similarity with multiple GSs, such as 3 (associated with homologous recombination deficiency) and 5 (pathogenesis unknown). Overall this clustering was maintained when EO-CRC samples were pooled with NO CRC. Grouped and correlation analysis revealed no significant association between age and individual GSs, including GS1 (associated with age). Conclusions: These preliminary analyses show that the relative contribution of known GS is similar in EO and NO cohorts of patients. Possible enrichment for EO-CRC in specific signature clusters will be analysed on a wider sample series.

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Age Related Disparities in Colorectal Cancer Patients

Journal of Clinical and Laboratory Research ◽

10.31579/2768-0487/064 ◽

2021 ◽

Vol 3 (3) ◽

pp. 01-04

Author(s):

Aliya Ishaq

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Cancer Patients ◽

Subgroup Analysis ◽

Colonic Cancer ◽

Age Distribution ◽

Young Population ◽

Age Related ◽

Population Subgroup ◽

Colorectal Cancer Patients

Background: There is an evident change in the colorectal cancer demographic over the period. This change is more marked in the age distribution and location of the tumor. It has practical implications, in regards to develop cancer awareness programs and screening protocols. Keeping in view that Pakistan is one of the countries with a high number of the young population this study is carried out to make a comparative analysis of this trend in our population. Material and methods: Colorectal cancer patients presented in Sindh Institute of urology and transplantation from January 2011 till December 2020 was reviewed retrospectively. All patients were divided into two groups, Group A young age population and Group B old age population. Subgroup analysis of study period was performed to check the progressive change in the trend of stage and clinical characteristics of colorectal cancer patients. Data reviewed from the patient’s files and collected as per Proforma requirement. Result: Total of 612 patients with colorectal cancer presented between 2011 till 2020.Among these patients 243 (39.7%) presented between January 2011 till December 2015. Patients age 50 years and younger were 410 (66.8%). Results showed a statistically significant association between and patient’s age and location of tumor such that left-sided colonic cancer and rectal cancer were more common in the young population. Subgroup analysis according to the study period showed that there is a change in the trend of disease presentation. Right-sided colonic cancer presentation decreased in the younger population over the period while simultaneously left-sided colonic cancer and rectal cancer presentation increased. Conclusion: The incidence of left-sided colonic and rectal cancer has been increased in the younger population over the specified period while there was no association between right-sided colon cancer and age noticed.

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Early-onset colorectal cancer: more than one side to the story

Colorectal Cancer ◽

10.2217/crc-2020-0016 ◽

2020 ◽

Vol 9 (3) ◽

pp. CRC28

Author(s):

Nina N Sanford ◽

Pooja Dharwadkar ◽

Caitlin C Murphy

Keyword(s):

Colorectal Cancer ◽

Early Onset ◽

Age Groups ◽

Younger Adults ◽

Risk Of Death ◽

Colon Cancers ◽

All Cause Mortality ◽

Colon And Rectum ◽

The Impact ◽

Early Onset Colorectal Cancer

Aim: To determine the impact of tumor sidedness on all-cause mortality for early- (age 18–49 years) and older-onset (age ≥50 years) colorectal cancer (CRC). Materials & methods: We conducted a retrospective study of 650,382 patients diagnosed with CRC between 2000 and 2016. We examined the associations of age, tumor sidedness (right colon, left colon and rectum) and all-cause mortality. Results: For early-onset CRC (n = 66,186), mortality was highest in the youngest age group (18–29 years), driven by left-sided colon cancers (vs 50–59 years, hazard ratio: 1.18; 95% CI: 1.03–1.34). 5-year risk of death among 18–29-year-olds with left-sided colon cancer (0.42, 95% CI: 0.38, 0.46) was higher than all other age groups. Conclusion: Left-sided colon cancers are enriched in younger adults and may be disproportionately fatal.

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The gut microbiome and potential implications for early-onset colorectal cancer

Colorectal Cancer ◽

10.2217/crc-2020-0007 ◽

2020 ◽

Vol 9 (3) ◽

pp. CRC25

Author(s):

Reetu Mukherji ◽

Benjamin A Weinberg

Keyword(s):

Colorectal Cancer ◽

Gut Microbiome ◽

Early Onset ◽

Older Patients ◽

Fusobacterium Nucleatum ◽

Distal Colon ◽

Gastrointestinal Cancers ◽

Human Gut ◽

Colon And Rectal Cancer ◽

Early Onset Colorectal Cancer

Recently, there has been an unexpected trend toward increased incidence of colorectal cancer in younger individuals, particularly distal colon and rectal cancer in those under age 50. There is evidence to suggest that the human gut microbiome may play a role in carcinogenesis. The microbiome is dynamic and varies with age, geography, ethnicity and diet. Certain bacteria such as Fusobacterium nucleatum have been implicated in the development of colorectal and other gastrointestinal cancers. Recent data suggest that bacteria can alter the inflammatory and immune environment, influencing carcinogenesis, lack of treatment response and prognosis. Studies to date focus on older patients. Because the microbiome varies with age, it could be a potential explanation for the rise in early-onset colorectal cancer.

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