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

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]

scholarly journals Effects of cancer screening restart strategies after COVID-19 disruption

2021 ◽  
Vol 124 (9) ◽  
pp. 1516-1523
Author(s):  
Lindy M. Kregting ◽  
Sylvia Kaljouw ◽  
Lucie de Jonge ◽  
Erik E. L. Jansen ◽  
Elleke F. P. Peterse ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Catching Up ◽  
Incidence And Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Catch Up ◽  
Microsimulation Models ◽  
The Impact

Abstract Background Many breast, cervical, and colorectal cancer screening programmes were disrupted due to the COVID-19 pandemic. This study aimed to estimate the effects of five restart strategies after the disruption on required screening capacity and cancer burden. Methods Microsimulation models simulated five restart strategies for breast, cervical, and colorectal cancer screening. The models estimated required screening capacity, cancer incidence, and cancer-specific mortality after a disruption of 6 months. The restart strategies varied in whether screens were caught up or not and, if so, immediately or delayed, and whether the upper age limit was increased. Results The disruption in screening programmes without catch-up of missed screens led to an increase of 2.0, 0.3, and 2.5 cancer deaths per 100 000 individuals in 10 years in breast, cervical, and colorectal cancer, respectively. Immediately catching-up missed screens minimised the impact of the disruption but required a surge in screening capacity. Delaying screening, but still offering all screening rounds gave the best balance between required capacity, incidence, and mortality. Conclusions Strategies with the smallest loss in health effects were also the most burdensome for the screening organisations. Which strategy is preferred depends on the organisation and available capacity in a country.

Colorectal cancer under the age of 50 years in U.S. Department of Veterans Affairs: Is there a role of early screening?

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4072-4072
Author(s):  
Abdul Moiz Khan ◽  
Zainub Ajmal ◽  
Usman Naseer ◽  
Darren Gemoets ◽  
Syed Arzoo Mehdi
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
African Americans ◽  
Age Groups ◽  
Stage Iii ◽  
Age Group ◽  
Early Screening ◽  
Screening Guidelines ◽  
Colon And Rectal Cancer

4072 Background: While the overall incidence of colorectal cancer (CRC) is decreasing, the rate has increased in population under 50, with higher stages at diagnosis and a greater proportion of African Americans (AA). Hence, there is an ongoing debate about the age of CRC screening. These trends have not been studied in the VA population. Methods: ICD-10 codes C18-C20 were used to identify the cases of colon and rectal cancer in National VA Cancer Cube Registry. 43,544 cases of colon cancer, 1,278 below and 42,254 above age 50, and 19,815 cases of rectal cancer, 862 below and 18,948 above age 50 were identified between 2003-17. Younger age group was defined as patients less than 50 years old. IRB approval was obtained. Results: Our data comprised > 97% of male patients. In younger group, in the 5 year periods, 2003-07, 2008-12 and 2013-17, colon cancer rate increased from 2.59% to 2.79% to 3.59%, while for rectal cancer it increased from 3.5% to 4.3% to 5.3% (p < .0001). Blacks comprise 31.6% cases of colon cancer and 27.15% cases of rectal cancer in under 50 group, compared to 18.5% and 15.9% of cases in above 50 group respectively (p < .0001). For under 50 group, 48.6% cases of colon and 42.2% cases of rectal cancer were diagnosed in stage III or IV compared to 35.7% and 34.05% cases in above 50 group respectively (p < .0001). For colon cancer, 51.87% of patients in the younger group have a < 5 year survival, worse compared to 45.05% in 50-60 group (p < .0001) and similar to 49.3% in 60-70 group (p = .08). For rectal cancer, 5 year survival showed no difference between these groups. Stage specific survival shows no difference for either colon or rectal cancer across < 50, 50-60 and 60-70 age groups. Conclusions: Rate of CRC is rising in < 50 age group with more advanced stage at diagnosis and higher proportion of African Americans. For colon cancer, < 50 group has a worse 5 year survival as compared to 50-60 age group likely due to increased proportion of patients in stage III or IV, as there is no difference in stage specific survival. For rectal cancer, the 5 year survival or stage specific survival shows no difference in < 50, 50-60 and 60-70 groups. These results add to our understanding of the trends of CRC and should be accounted for in the screening guidelines.

scholarly journals Cancer Incidence and Mortality in the Oldest Old: a Nationwide Study in Finland

2020 ◽  
Author(s):  
Tomas Tanskanen ◽  
Karri J M Seppä ◽  
Anni Virtanen ◽  
Nea K Malila ◽  
Janne M Pitkäniemi
Keyword(s):  
Cancer Incidence ◽  
Excess Mortality ◽  
Oldest Old ◽  
Cancer Registries ◽  
Age Group ◽  
Incidence And Mortality ◽  
Specific Cancer ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Related Mortality

Abstract The world’s population is aging rapidly. This study reports the burden of cancer in the oldest old (≥85 years) in Finland in 1953-2017 and estimates age-specific cancer rates in the old population (65-99 years) in 1988-2017. The Finnish Cancer Registry provided data on all cancer diagnoses, cancer deaths and other deaths in cancer patients in Finland in 1953-2017. Between 1953-1957 and 2013-2017, the proportion of incident cancers in those aged ≥85 years increased from 1.5% to 9.6% (597 to 15,360 new cases), and in 2013-2017, more new cancers were diagnosed at age ≥85 years than age &lt;50 years. Cancer incidence and excess mortality attributable to cancer peaked at age 85-94 years and declined subsequently, whereas cancer-specific mortality continued to increase or plateaued. Due to demographic changes, the number of new cancers in the oldest old has increased substantially in Finland, and currently, nearly one in 10 cancers are diagnosed in this age group. The increasing cancer burden in the oldest old poses a major challenge for healthcare and needs to be addressed in designing clinical research and reporting of cancer registries. In old populations with competing risks of death, we propose excess cancer mortality as a measure of cancer-related mortality.

AGE PECULIARITIES OF COLORECTAL CANCER INCIDENCE IN THE REPUBLIC OF BASHKORTOSTAN

2019 ◽  
Vol 25 (2) ◽  
pp. 100-103
Author(s):  
M. Yu. Pavlova ◽  
L. P Dautova ◽  
Nazira Kh. Sharafutdinova ◽  
R. Z Sultanov
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Urban Areas ◽  
Age Groups ◽  
Malignant Neoplasms ◽  
Age Group ◽  
Newly Diagnosed ◽  
Republic Of Bashkortostan ◽  
The Republic

In the Russian Federation in recent years, there has been an increase in the incidence of colorectal cancer. The probability of the disease with colorectal cancer increases after 40 years and sharply increases after 50 years. Aim. To study the age-specific features of the prevalence of colorectal cancer in the Republic of Bashkortostan. Materials and methods. As the research materials, the form of Federal statistical observation No. 7 “Information on the incidence of malignant neoplasms” was used in the Republic of Bashkortostan for 2008-2016. The indicators of the incidence of colorectal and rectum cancer per 100 thousand of the population, depending on age and sex, are calculated. Results and discussion. The lowest incidence of colorectal cancer was observed in the age group up to 30 years, the largest - at the age of 70 years and older. For the years 2008-2016 the proportion of patients younger than 50 years with newly diagnosed colon cancer increased from 8.1% to 9.0% and rectum from 7.2% to 8.1%. In this age group there was an increase in primary incidence of colorectal cancer among men by 84.0%, among women by 50.0%, rectal cancer by 54.2% and 68.0%, respectively. The decrease in the incidence of colorectal cancer in the age group of 70 years and older. The average annual incidence rate of colorectal cancer was higher among men than among women in the age groups 50-59, 60-69 years and 70 years and older, rectal cancer in all age groups, with differences increasing with age. During the observation period, the mean age of patients with newly diagnosed colon cancer was reduced by 1.5 years, rectal by 1.3 years. Among patients with colorectal cancer living in urban areas, the average age was higher than in rural areas. The conclusion. The revealed sex-age features of the prevalence of colorectal cancer were used in the development of measures to improve medical care for patients.

scholarly journals Increasing Incidence of Colorectal Cancer in Young Adults

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Holli A. Loomans-Kropp ◽  
Asad Umar
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Early Onset ◽  
Population Level ◽  
Distal Colon ◽  
Incidence Rates ◽  
Anatomical Distribution ◽  
Colon Cancers ◽  
Age Related ◽  
Incidence And Mortality

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.

Metabolic syndrome, metabolic comorbid conditions and risk of early-onset colorectal cancer

Gut ◽  
2020 ◽  
pp. gutjnl-2020-321661 ◽  
Author(s):  
Hanyu Chen ◽  
Xiaobin Zheng ◽  
Xiaoyu Zong ◽  
Zitong Li ◽  
Na Li ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metabolic Syndrome ◽  
Colon Cancer ◽  
Early Onset ◽  
Distal Colon ◽  
Comorbid Condition ◽  
Comorbid Conditions ◽  
Metabolic Dysregulation ◽  
Increased Risk ◽  
Early Onset Colorectal Cancer

ObjectiveFactors that lead to metabolic dysregulation are associated with increased risk of early-onset colorectal cancer (CRC diagnosed under age 50). However, the association between metabolic syndrome (MetS) and early-onset CRC remains unexamined.DesignWe conducted a nested case–control study among participants aged 18–64 in the IBM MarketScan Commercial Database (2006–2015). Incident CRC was identified using pathologist-coded International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, and controls were frequency matched. MetS was defined as presence of ≥3 conditions among obesity, hypertension, hyperlipidaemia and hyperglycaemia/type 2 diabetes, based on ICD-9-CM and use of medications. Multivariable logistic regressions were used to estimate ORs and 95% CIs.ResultsMetS was associated with increased risk of early-onset CRC (n=4673; multivariable adjusted OR 1.25; 95% CI 1.09 to 1.43), similar to CRC diagnosed at age 50–64 (n=14 928; OR 1.21; 95% CI 1.15 to 1.27). Compared with individuals without a metabolic comorbid condition, those with 1, 2 or ≥3 conditions had a 9% (1.09; 95% CI 1.00 to 1.17), 12% (1.12; 95% CI 1.01 to 1.24) and 31% (1.31; 95% CI 1.13 to 1.51) higher risk of early-onset CRC (ptrend <0.001). No associations were observed for one or two metabolic comorbid conditions and CRC diagnosed at age 50–64. These positive associations were driven by proximal (OR per condition 1.14; 95% CI 1.06 to 1.23) and distal colon cancer (OR 1.09; 95% CI 1.00 to 1.18), but not rectal cancer (OR 1.03; 95% CI 0.97 to 1.09).ConclusionsMetabolic dysregulation was associated with increased risk of early-onset CRC, driven by proximal and distal colon cancer, thus at least in part contribute to the rising incidence of early-onset CRC.

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