Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019 Oct;68(10):1820-1826.
doi: 10.1136/gutjnl-2018-317592. Epub 2019 May 16.

Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years

Fanny Er Vuik  1 , Stella Av Nieuwenburg  1 , Marc Bardou  2   3 , Iris Lansdorp-Vogelaar  2 , Mário Dinis-Ribeiro  4   5 , Maria J Bento  6 , Vesna Zadnik  7 , María Pellisé  8 , Laura Esteban  9 , Michal F Kaminski  10   11   12 , Stepan Suchanek  13 , Ondřej Ngo  14   15 , Ondřej Májek  14   15 , Marcis Leja  16 , Ernst J Kuipers  1 , Manon Cw Spaander  1
Affiliations
Multicenter Study

Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years

Fanny Er Vuik et al. Gut. 2019 Oct.

Abstract

Objective: The incidence of colorectal cancer (CRC) declines among subjects aged 50 years and above. An opposite trend appears among younger adults. In Europe, data on CRC incidence among younger adults are lacking. We therefore aimed to analyse European trends in CRC incidence and mortality in subjects younger than 50 years.

Design: Data on age-related CRC incidence and mortality between 1990 and 2016 were retrieved from national and regional cancer registries. Trends were analysed by Joinpoint regression and expressed as annual percent change.

Results: We retrieved data on 143.7 million people aged 20-49 years from 20 European countries. Of them, 187 918 (0.13%) were diagnosed with CRC. On average, CRC incidence increased with 7.9% per year among subjects aged 20-29 years from 2004 to 2016. The increase in the age group of 30-39 years was 4.9% per year from 2005 to 2016, the increase in the age group of 40-49 years was 1.6% per year from 2004 to 2016. This increase started earliest in subjects aged 20-29 years, and 10-20 years later in those aged 30-39 and 40-49 years. This is consistent with an age-cohort phenomenon. Although in most European countries the CRC incidence had risen, some heterogeneity was found between countries. CRC mortality did not significantly change among the youngest adults, but decreased with 1.1%per year between 1990 and 2016 and 2.4% per year between 1990 and 2009 among those aged 30-39 years and 40-49 years, respectively.

Conclusion: CRC incidence rises among young adults in Europe. The cause for this trend needs to be elucidated. Clinicians should be aware of this trend. If the trend continues, screening guidelines may need to be reconsidered.

Keywords: colorectal cancer; epidemiology; screening.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Annual percent change (APC) in colorectal cancer (CRC) incidence from the European countries included in the analysis in adults aged 20–39 years, 1990–2016. Light green to dark green: significant increase in CRC incidence rate; blue: significant decrease in CRC incidence rate; grey: no significant trend.
Figure 2
Figure 2
Annual percent change (APC) in age-specific colorectal cancer (CRC), colon cancer and rectal cancer incidence rates in Europe, 1990–2016. *Indicates that APC is statistically significant different from zero.
Figure 3
Figure 3
Annual percent change (APC) in age-specific colorectal cancer (CRC), colon cancer and rectal cancer incidence rates in nine European countries, 1991–2014. Analyses on trend in incidence of CRC was based on nine countries: Slovenia, Norway, Denmark, Sweden, Finland, the Netherlands, Czech Republic, Switzerland and Greenland. Analyses on trend of incidence of colon cancer and rectum cancer was based on eight countries: Slovenia, Norway, Denmark, Sweden, Finland, the Netherlands, Czech Republic and Greenland. *Indicates that APC is statistically significant different from zero.
Figure 4
Figure 4
Annual percent change (APC) in age-specific colorectal cancer (CRC), colon cancer and rectal cancer mortality rates in Europe, 1990–2016. *Indicates that APC is statistically significant different from zero.
See this image and copyright information in PMC

Comment in

References

    1. Arnold M, Sierra MS, Laversanne M, et al. . Global patterns and trends in colorectal cancer incidence and mortality. Gut 2017;66:683–91. 10.1136/gutjnl-2015-310912 - DOI - PubMed
    1. Doubeni CA, Corley DA, Quinn VP, et al. . Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: a large community-based study. Gut 2018;67:291–8. 10.1136/gutjnl-2016-312712 - DOI - PMC - PubMed
    1. Rosato V, Bosetti C, Levi F, et al. . Risk factors for young-onset colorectal cancer. Cancer Causes Control 2013;24:335–41. 10.1007/s10552-012-0119-3 - DOI - PubMed
    1. Siegel RL, Fedewa SA, Anderson WF, et al. . Colorectal cancer incidence patterns in the United States, 1974-2013. J Natl Cancer Inst 2017:109. - PMC - PubMed
    1. Fitzmaurice C, Dicker D, Pain A, et al. . The Global Burden of Cancer 2013. JAMA Oncol 2015;1:505–27. 10.1001/jamaoncol.2015.0735 - DOI - PMC - PubMed

Publication types