Young Adult CRC Incidence May be Rising in USA

Colorectal cancer in young adults in the USA bucks the general trend towards a reduced incidence of the disease

medwireNews: Surveillance, Epidemiology, and End Results cohort data suggest that the incidence of localised, regional and distant colorectal cancer (CRC) is increasing among young people in the USA.

Between 1975 and 2010, the incidence of CRC among patients aged 20 to 34 years significantly increased by an annual percentage change (APC) of 1.99, say George Chang, from the University of Texas MD Anderson Cancer Center in Houston, USA, and co-workers.

This contrasts with a significant -0.92 APC in the overall incidence of CRC over the same period and a significant –1.15 APC drop in the incidence for patients aged 75 years and older, they report in JAMA Surgery.

Should the increase in the incidence of CRC diagnosis in young patients continue at the same rate, 10.9% of colon cancer and 22.9% of rectal cancer diagnoses by 2030 will occur in patients who are aged less than 50 years old, the recommended time to begin CRC screening, the researchers highlight.

“In the absence of routine screening, patients and healthcare professionals may need to have a heightened awareness regarding [CRC] risk and its increasing incidence to minimize delays in both diagnosis and treatment, as well as missed opportunities for treatment of precursor lesions resulting from delays in seeking medical attention”, George Chang et al emphasise.

Writing in an accompanying commentary, Kiran Turaga, from the Medical College of Wisconsin in Milwaukee, USA, notes that the increased incidence in young adults may, in part, be due to greater use of imaging techniques in symptomatic patients.

While recommending further research into a rising incidence in young adults and possible causes for such a phenomenon, he cautions that absolute incidence in individuals aged 20 to 34 years would be just 1% of the overall CRC population.

“Hence, widespread application of colonoscopic screening might add significant cost and risk without societal benefit”, writes Kiran Turaga.

“However, this report should stimulate opportunities for development of better risk-prediction tools that might help us identify these individuals early and initiate better screening/prevention strategies.”

References

Bailey CE, Hu C-Y, You N, et al. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010. JAMA Surgery; Advance online publication 5 November 2014 doi:10.1001/jamasurg.2014.1756

Turaga KK. Screening young adults for nonhereditary colorectal cancer. JAMA Surgery; Advance online publication 5 November 2014 doi:10.1001/jamasurg.2014.1765

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