Increasing Disparities in the Age-Related Incidences of Colon and Rectal Cancers in the United States, 1975-2010

Bailey, Christina E.; Hu, Chung Yuan; You, Y. Nancy; Bednarski, Brian Keith; Rodrı́guez-Bigas, Miguel A.; Skibber, John M.; Cantor, Scott B.; Chang, George J.

doi:10.1001/jamasurg.2014.1756

Cited by 854 publications

(768 citation statements)

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“…We found that age‐adjusted invasive CRC incidence rates in younger adults (20‐49) have risen significantly since the mid‐1990s in NJ, similar to the increase in US younger adults 1, 2, 3, 4, 5, 6. This contrasts with older adults (≥50) in NJ and the US whose CRC incidence rates have declined significantly for several decades 1, 2, 3, 4, 5, 6.…”

Section: Discussionmentioning

confidence: 62%

“…This contrasts with older adults (≥50) in NJ and the US whose CRC incidence rates have declined significantly for several decades 1, 2, 3, 4, 5, 6. CRC incidence rates are increasing the fastest among the youngest adults ages 20‐39.…”

Section: Discussionmentioning

confidence: 97%

“…Recent studies indicate colorectal cancer (CRC) has been rising in younger adults who are under the recommended screening age of 50 1, 2, 3, 4, 5, 6, 7. In New Jersey (NJ), an average of 435 younger adults (approximately 10% of all CRC cases) are diagnosed each year 8.…”

Section: Introductionmentioning

confidence: 99%

“…The latest research, using age‐period‐cohort modeling, found that US adults born around 1990 have double the risk of colon cancers and quadruple the risk of rectal cancer compared to adults born around 1950 1. Prior studies have analyzed race/ethnicity and sex,1, 2, 3, 4, 5, 6 but the authors are not aware of studies in NJ or the US which have examined trends by age, sex, race, ethnicity, and subsite in combination in younger adults with CRC. Right‐ and left‐sided colon cancers have markedly different underlying biological characteristics, and are distinct from rectal cancers.…”

Section: Introductionmentioning

confidence: 99%

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Trends in colorectal cancer incidence among younger adults—Disparities by age, sex, race, ethnicity, and subsite

et al. 2018

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Millennials (ages 18‐35) are now the largest living generation in the US, making it important to understand and characterize the rising trend of colorectal cancer incidence in this population, as well as other younger generations of Americans. Data from the New Jersey State Cancer Registry (n = 181 909) and Surveillance, Epidemiology, and End Results program (n = 448 714) were used to analyze invasive CRC incidence trends from 1979 to 2014. Age, sex, race, ethnicity, subsite, and stage differences between younger adults (20‐49) and screening age adults (≥50) in New Jersey (NJ) were examined using chi‐square; and, we compared secular trends in NJ to the United States (US). Whites, men, and the youngest adults (ages 20‐39) are experiencing greater APCs in rectal cancer incidence. Rates among younger black adults, overall, were consistently higher in both NJ and the US over time. When compared to older adults, younger adults with CRC in NJ were more likely to be: diagnosed at the late stage, diagnosed with rectal cancer, male, non‐white, and Hispanic. Invasive CRC incidence trends among younger adults were found to vary by age, sex, race, ethnicity, and subsite. Large, case‐level, studies are needed to understand the role of genetics, human papillomavirus (HPV), and cultural and behavioral factors in the rise of CRC among younger adults. Provider and public education about CRC risk factors will also be important for preventing and reversing the increasing CRC trend in younger adults.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trends in colorectal cancer incidence among younger adults—Disparities by age, sex, race, ethnicity, and subsite

et al. 2018

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“…Indeed, age is a very powerful predictor for the development of precursor adenomas and CRC, with approximately 94.5 % of all CRCs occurring after age 50, the age at which universal CRC screening is recommended for men and women [2], although 5.5 % of all CRCs occur before age 50, when general screening is not offered or recommended unless there is a strong family history of CRC, when screening is recommended to commence at age 40 [2,3]. Over a 25-year period in a cohort of nearly 400,000 CRC patients, the incidence of CRC was reduced by 0.92 %, although this decline only occurred in subjects [age 50, and largely attributed to screening implementation [5]. Following current trends, the incidence of colon and rectal cancer are projected to increase 124 and 90 % in subjects aged 20-34 and 27.7 and 46.0 % in subjects aged 35-49, respectively, by 2030 [5], with rectal cancer diagnosed in about two-thirds of patients \50 years [6].…”

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confidence: 99%

The Increasing Incidence of Colorectal Cancers Diagnosed in Subjects Under Age 50 Among Races: CRaCking the Conundrum

Carethers

2016

Dig Dis Sci

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In the USA in 2016, 134,490 cases of colorectal cancer (CRC) will be diagnosed and 49,190 people will die from this disease [1]. Contributors to CRC risk for patients include age, family history, and race, as well as potentially modifiable factors such as diet, the intestinal microbiome, socioeconomic factors, physical activity, and screening utilization rates [2][3][4]. Screening, in particular, can reduce CRC mortality due to the identification and removal of precursor adenomas and potentially curable early-stage cancers; screening efficacy is manifest in the reduced CRC incidence in the USA attributed to increasing screening rates among the population [2,3]. Colonoscopic CRC surveillance likely further contributes to reduced CRC incidence and CRC-related death, particularly for patients with prior colonic neoplasms, or patients with a strong family history whether or not they have undergone any genetic evaluation for a familial syndrome.The distribution of CRC deaths is not linear with age, with 79.1 % of deaths occurring after age 60 (Table 1) [1]. Indeed, age is a very powerful predictor for the development of precursor adenomas and CRC, with approximately 94.5 % of all CRCs occurring after age 50, the age at which universal CRC screening is recommended for men and women [2], although 5.5 % of all CRCs occur before age 50, when general screening is not offered or recommended unless there is a strong family history of CRC, when screening is recommended to commence at age 40 [2,3]. Over a 25-year period in a cohort of nearly 400,000 CRC patients, the incidence of CRC was reduced by 0.92 %, although this decline only occurred in subjects [age 50, and largely attributed to screening implementation [5]. Following current trends, the incidence of colon and rectal cancer are projected to increase 124 and 90 % in subjects aged 20-34 and 27.7 and 46.0 % in subjects aged 35-49, respectively, by 2030 [5], with rectal cancer diagnosed in about two-thirds of patients \50 years [6]. While these trends are alarming, the absolute number of CRC patients in the \50 years group is still relatively small (Table 1); however, their proportion will increase relatively with continued successful screening and subsequent declines in CRC incidence among the [50 years group. Moreover, vigilance for a potentially inherited form of CRC must be strongly considered when a patient aged \50 years is diagnosed with this disease [7]. At present, other than heightened vigilance and evaluation of patients with a strong family history of cancer, there is no current screening strategy to address this \50 years group since it is not cost-effective as with the [age 50 years group [8].Like age, the distribution of and risk of CRC among racial and ethnic groups are not identical, with a clear disparity for African Americans for CRC incidence and death (Table 2) [1,2,9]. In conjunction with the higher incidence and death rates, African American CRC patients are initially diagnosed as many as 5-8 years earlier in age (median age of first diagnosis for...

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Young Age and Aggressive Treatment in Colon Cancer

Berian

Benson

2015

JAMA

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The downward trend in colorectal cancer (CRC) incidence and mortality over the past several decades 1 has not held true for young patients. Currently, CRC incidence in patients younger than 50 years continues to increase, most markedly among those younger than 35 years by approximately 2% per year. This trend was identified in a recent analysis that estimated patients younger than screening age (ie, age 50 years) will comprise 10.9% of colon and 22.9% of rectal cancers by 2030, compared with 4.8% and 9.5% in 2010, respectively. 2 Young-onset CRC is characterized by more advanced stages, poor tumor differentiation, mucinous carcinoma, more distal location, and even a particular profile of biomarkers. 3 Although more aggressive disease usually results in worse outcomes, disease-specific and overall survival for patients with young-onset CRC consistently matches or surpasses that of older patients, stage-for-stage. 3 Given this seemingly conflicting information, optimal treatment for these young patients remains unclear.

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Increasing Disparities in the Age-Related Incidences of Colon and Rectal Cancers in the United States, 1975-2010

Cited by 854 publications

References 19 publications

Trends in colorectal cancer incidence among younger adults—Disparities by age, sex, race, ethnicity, and subsite

Trends in colorectal cancer incidence among younger adults—Disparities by age, sex, race, ethnicity, and subsite

The Increasing Incidence of Colorectal Cancers Diagnosed in Subjects Under Age 50 Among Races: CRaCking the Conundrum

Young Age and Aggressive Treatment in Colon Cancer

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