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. 2023 Feb 3;120(Forthcoming):59-64.
doi: 10.3238/arztebl.m2022.0368.

The Rising Incidence of Early-Onset Colorectal Cancer

Luana Fiengo Tanaka  1 , Sieglinde Hechenbichler Figueroa, Vera Popova, Stefanie J Klug, Nina Buttmann-Schweiger
Affiliations

The Rising Incidence of Early-Onset Colorectal Cancer

Luana Fiengo Tanaka et al. Dtsch Arztebl Int. .

Abstract

Background: The incidence of early-onset (diagnosis before age 50) colorectal cancer (EOCRC) is increasing in some high-income countries. In this study, we examined the trends in EO-CRC incidence in Germany.

Methods: We obtained data on CRC (ICD-10 C18-C20) incidence from the Centre for Cancer Registry Data (excluding cases reported via death certificate only) and on mortality from the official cause of death statistics for 1999-2018 from registries with sufficient incidence coverage. To assess time trends for persons aged 20-49 we calculated the average annual percent changes (AAPC) and corresponding 95% confidence intervals (95% CI). The incidence analyses were stratified by sex, site (proximal colon, distal colon, rectum), age group (20-29, 30-39, and 40-49) and tumor size (T).

Results: EO-CRC accounted for 5.1% (9529 cases) of all colorectal cancers in the selected German regions. The EO-CRC incidence rose annually by 1.16% (95% CI: [0.51; 1.81]) in men and 1.32% [0.80; 1.84] in women. The incidence of proximal colon cancer increased in both sexes (men: AAPC = 3.26 [2.00; 4.53]; women: AAPC = 2.99 [2.17; 3.83]), while the incidence of distal colon cancer remained unchanged.

Conclusion: The incidence of EO-CRC in Germany is rising. The reasons are probably multifactorial, reflecting the changing prevalence of early life exposure to risk and protective factors.

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Figures

Figure
Figure
Trends in the incidence and mortality of early-onset colorectal cancer (20–49 years), by sex, in Germany (Bremen, Hamburg, Münster, Rhineland–Palatinate, Saarland, and Schleswig–Holstein) from 1999 to 2018 AAPC, Average annual percentage change; CI, confidence interval; *1 statistically significantly increasing trend; *2 statistically significantly decreasing trend
eFigure
eFigure
Trends in the incidence and mortality of early-onset colorectal cancer (20–49 years), by 10-year age group and sex, in Germany (Bremen, Hamburg, Münster, Rhineland–Palatinate, Saarland, and Schleswig–Holstein) from 1999 to 2018 Note: Different y-axis ranges were used. AAPC, Average annual percentage change; CI, confidence interval; *1 statistically significantly increasing trend; *2 statistically significantly decreasing trend
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