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
. 2020 Apr 6;20(1):288.
doi: 10.1186/s12885-020-06766-9.

Trends in the epidemiology of young-onset colorectal cancer: a worldwide systematic review

Khalid Saad El Din  1   2 , Jonathan M Loree  3   4 , Eric C Sayre  5 , Sharlene Gill  3   4 , Carl J Brown  6   7 , Hallie Dau  1   2 , Mary A De Vera  8   9   10
Affiliations

Trends in the epidemiology of young-onset colorectal cancer: a worldwide systematic review

Khalid Saad El Din et al. BMC Cancer. .

Abstract

Background: Recent data suggest that the risk of young-onset colorectal cancer (yCRC), in adults less than 50 years of age, is increasing. To confirm findings and identify contemporary trends worldwide, we conducted a systematic review of studies examining population-level trends in yCRC epidemiology.

Methods: We searched MEDLINE (1946-2018), EMBASE (1974-2018), CINAHL (1982-2018), and Cochrane Database of Systematic Reviews (2005-2018) for studies that used an epidemiologic design, assessed trends in yCRC incidence or prevalence, and published in English. Extracted information included country, age cut-off for yCRC, and reported trends in incidence or prevalence (e.g. annual percent change [APC]). We pooled similarly reported trend estimates using random effects models.

Results: Our search yielded 8695 articles and after applying our inclusion criteria, we identified 40 studies from 12 countries across five continents. One study assessed yCRC prevalence trends reporting an APCp of + 2.6 and + 1.8 among 20-39 and 40-49 year olds, respectively. 39 studies assessed trends in yCRC incidence but with substantial variability in reporting. Meta-analysis of the most commonly reported trend estimate yielded a pooled overall APCi of + 1.33 (95% CI, 0.97 to 1.68; p < 0.0001) that is largely driven by findings from North America and Australia. Also contributing to these trends is the increasing risk of rectal cancer as among 14 studies assessing cancer site, nine showed an increased risk of rectal cancer in adults less than 50 years with APCi up to + 4.03 (p < 0.001).

Conclusions: Our systematic review highlights increasing yCRC risk in North America and Australia driven by rising rectal cancers in younger adults over the past two decades.

Keywords: Cancer; Epidemiology; Incidence; Meta-analysis; Young-adult cancer.

PubMed Disclaimer

Conflict of interest statement

The authors have nothing to declare.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for systematic review. This figure summarizes systematic review steps, combining the broad and specific search strategies as described in the Methods. Reporting is in accordance to Preferred Reporting for Items for Systematic Review and Meta-Analysis (PRISMA)
See this image and copyright information in PMC

References

    1. Aran V, Victorino AP, Thuler LC, Ferreira CG. Colorectal Cancer: epidemiology, disease mechanisms and interventions to reduce onset and mortality. Clin Colorectal Cancer. 2016;15(3):195–203. doi: 10.1016/j.clcc.2016.02.008. - DOI - PubMed
    1. Ferlay J, Parkin DM, Steliarova-Foucher E. Estimates of cancer incidence and mortality in Europe in 2008. Eur J Cancer. 2010;46(4):765–781. doi: 10.1016/j.ejca.2009.12.014. - DOI - PubMed
    1. Abdelsattar ZM, Wong SL, Regenbogen SE, Jomaa DM, Hardiman KM, Hendren S. Colorectal cancer outcomes and treatment patterns in patients too young for average-risk screening. Cancer. 2016;122(6):929–934. doi: 10.1002/cncr.29716. - DOI - PMC - PubMed
    1. Siegel RL, Jemal A, Ward EM. Increase in incidence of colorectal cancer among young men and women in the United States. Cancer Epidemiol Biomark Prev. 2009;18(6):1695–1698. doi: 10.1158/1055-9965.EPI-09-0186. - DOI - PubMed
    1. Nancy You Y, Xing Y, Feig BW, Chang GJ, Cormier JN. Young-onset colorectal cancer: is it time to pay attention? Arch Intern Med. 2012;172(3):287–289. doi: 10.1001/archinternmed.2011.602. - DOI - PubMed

Publication types