Disparities in Early-Onset Colorectal Cancer

Abstract

The incidence and mortality of early-onset colorectal cancer (CRC) are increasing in the United States (US) and worldwide. In the US, there are notable disparities in early-onset CRC burden by race/ethnicity and geography. African Americans, Hispanic/Latinos, and populations residing in specific regions of the Southern U.S. are disproportionately affected with CRC diagnosed at younger ages, while less is known about disparities in other countries. Reasons for these disparities are likely multi-factorial and potentially implicate differences in health determinants including biology/genetics, diet/environment, individual health behaviors, and access to high-quality health services, as well as social and policy factors. This review summarizes current understanding of early-onset CRC disparities and identifies specific research areas that will inform evidence-based interventions at individual, practice, and policy levels to reduce the global burden of this disease.

Keywords: colorectal cancer; disparities; early onset.

Figure 1

Age-standardized incidence rate during 2008–2021 for colorectal cancer among adults ages 20–49 years worldwide. Shading indicates trend in incidence rates based on 10-year average annual % change; blue, significant increase; red, significant decrease. The figure was recreated by using the incidence rates from Siegel et al. 2019 [5].

Figure 2

Observed incidence rates of colorectal cancer by race/ethnicity, both sexes, ages 20–49 years, United States, 2000–2017 from the SEER registry [39].

Figure 3

Incidence rates of early-onset CRC (Ages < 50) by US state, 2013–2017 from SEER registry [39].