The incidence of colorectal cancer in adults younger than 50 years of age has increased in the United States since 1970. A new study published early online in CANCER , a peer-reviewed journal of the American Cancer Society, found that the proportion of adults diagnosed with colorectal cancer under age 50 in the United States has continued to increase over the past decade, and younger adults are diagnosed with more advanced disease.
To determine recent trends in colorectal cancer rates, Boone Goodgame, MD, of The University of Texas at Austin, and his colleagues examined information from the National Cancer Database registry, which includes more than 70 percent of new cancer cases in the United States. From 2004 to 2015 (the most recent year included in the database), 130,165 patients under age 50 and 1,055,598 patients over age 50 were diagnosed with colorectal cancer.
Among the major findings:
"Several studies have shown that the rates of colorectal cancer in younger adults have risen slowly in the US since the 1970s, but for practicing physicians, it feels like we are seeing more and more young people with colorectal cancer now than we were even 10 years ago," said Dr. Goodgame. "Until just last year, guidelines recommended colon cancer screening beginning at 50. Now many guidelines do recommend screening at age 45, but most physicians and patients don't appear to be following those recommendations."
Dr. Goodgame noted that the cause of increasing rates of colorectal cancer in younger patients is unclear, but emerging research suggests that it may be a combination of increases in body weight and changes in gastrointestinal bacteria.
In an accompanying editorial, Chyke Doubeni, MD, MPH, of the University of Pennsylvania, pointed to the need for additional research. "Because the number of colorectal cancer cases from inherited causes are much higher in younger individuals, it is unknown whether screening for sporadic cases in a group with such low disease rate can result in a favorable balance of harms and benefits," he wrote. "It is therefore imperative that the various hypotheses for increasing colorectal cancer incidence among people younger than 50 be rigorously tested to determine if changing the current screening age in people who are not at increased familial risk represents the most appropriate public health response."
The American Cancer Society's guideline for colorectal cancer screening recommends that average-risk adults aged 45 years and older undergo regular screening, either with colonoscopy or with alternatives such as fecal immunochemical tests and fecal occult blood tests.
###
This research was supported by the National Cancer Institute through U01CA174706 and U01CA142565 and by the Cancer Prevention and Research Institute of Texas through RR160005.
Additional information
NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. A free abstract of this article will be available via the Cancer News Room upon online publication. For more information or to obtain a PDF of any study, please contact:
Penny Smith +44 (0) 1243 770448 (UK)
newsroom@wiley.com
Follow us on Twitter @WileyNews
Full Citations:
"Recent trends in age at diagnosis of colorectal cancer in the United States National Cancer Database, 2004 - 2015." John Virostko, Anna Capasso, Thomas E. Yankeelov, and Boone Goodgame. CANCER ; Published Online: July 22, 2019 (DOI: 10.1002/cncr.32347).
URL Upon Publication: http://doi.wiley.com/10.1002/cncr.32347
"Early-onset colorectal cancer: what reported statistics can and can't tell us, and their implications." Chyke A. Doubeni. CANCER ; Published Online: July 22, 2019 (DOI: 10.1002/cncr.32346).
URL Upon Publication: http://doi.wiley.com/10.1002/cncr.32346
Author Contact: Boone Goodgame, MD, The University of Texas at Austin, bgoodgame@utexas.edu
About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online.
Follow us on Twitter @JournalCancer
About Wiley
Wiley drives the world forward with research and education. Through publishing, platforms and services, we help students, researchers, universities, and corporations to achieve their goals in an ever-changing world. For more than 200 years, we have delivered consistent performance to all of our stakeholders. The Company's website can be accessed at http://www.wiley.com .
Cancer