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. 2022 Jun;20(6):e1365-e1377.
doi: 10.1016/j.cgh.2021.07.035. Epub 2021 Jul 26.

Trends in Early-onset vs Late-onset Colorectal Cancer Incidence by Race/Ethnicity in the United States Cancer Statistics Database

Steven H Chang  1 , Nicolas Patel  1 , Mengmeng Du  2 , Peter S Liang  3
Affiliations

Trends in Early-onset vs Late-onset Colorectal Cancer Incidence by Race/Ethnicity in the United States Cancer Statistics Database

Steven H Chang et al. Clin Gastroenterol Hepatol. 2022 Jun.

Abstract

Background & aims: Colorectal cancer (CRC) incidence has decreased overall in the last several decades, but it has increased among younger adults. Prior studies have characterized this phenomenon in the United States (U.S.) using only a small subset of cases. We describe CRC incidence trends using high-quality data from 92% of the U.S. population, with an emphasis on those younger than 50 years.

Methods: We obtained 2001 to 2016 data from the U.S. Cancer Statistics database and analyzed CRC incidence for all age groups, with a focus on individuals diagnosed at ages 20 to 49 years (early-onset CRC). We compared incidence trends stratified by age, as well as by race/ethnicity, sex, region, anatomic site, and stage at diagnosis.

Results: We observed 191,659 cases of early-onset and 1,097,765 cases of late-onset CRC during the study period. Overall, CRC incidence increased in every age group from 20 to 54 years. Whites were the only racial group with a consistent increase in incidence across all younger ages, with the steepest rise seen after 2012. Hispanics also experienced smaller increases in incidence in most of the younger age groups. Asians/Pacific Islanders and blacks saw no increase in incidence in any age group in 2016, but blacks continued to have the highest incidence of CRC for every age group. Greater increase in early-onset CRC incidence was observed for males, left-sided tumors, and regional and distant disease.

Conclusions: Early-onset CRC incidence increased overall from 2001 to 2016, but the trends were markedly different for whites, blacks, Asians/Pacific Islanders, and Hispanics. These results may inform future research on the risk factors underlying early-onset CRC.

Keywords: Colorectal Cancer; Early-onset; Race; Young Adult.

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Conflict of interest statement

Conflict of Interest Disclosure:

No competing interests. No support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1:
Figure 1:
Incidence of colorectal cancer (2001-2016), stratified by age A: CRC incidence, age 20-49; B: CRC incidence, age 50-74
Figure 2:
Figure 2:
Incidence of early-onset colorectal cancer (2001-2016), stratified by age and race/ethnicity API, Asian/Pacific Islander
Figure 3:
Figure 3:
Incidence of colorectal cancer (2001-2016), stratified by age and sex
Figure 4:
Figure 4:
Incidence of colorectal cancer (2001-2016), stratified by age and anatomic site
Figure 5:
Figure 5:
Incidence of colorectal cancer (2001-2016), stratified by age and stage of disease
See this image and copyright information in PMC

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