Increasing Incidence of Colorectal Cancer in Adolescents and Young Adults Aged 15–39 Years in Western Australia 1982–2007: Examination of Colonoscopy History

Troeung, Lakkhina; Sodhi-Berry, Nita; Martini, Angelita; Malacova, Eva; Ee, Hooi C.; O’Leary, Peter; Lansdorp–Vogelaar, Iris; Preen, David B.

doi:10.3389/fpubh.2017.00179

Cited by 71 publications

(65 citation statements)

References 39 publications

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“…Our findings are consistent with previous work in Australia (8)(9)(10) but provide a greater level of detail over a longer time period, with information on specific trends in colon and rectal cancer, with the inclusion of over 375,000 cases in our analysis. A previous study analyzed incidence rates from 1990, 1995, 2000, 2005, and 2010 and found that colorectal cancer incidence was increasing for those under 40 years of age but was stable or declining in those ages 40 to 59 years (9).…”

Section: Discussionsupporting

confidence: 91%

Trends in Colon and Rectal Cancer Incidence in Australia from 1982 to 2014: Analysis of Data on Over 375,000 Cases

Feletto

Lew

et al. 2019

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Colorectal cancer is the third most commonly diagnosed cancer in Australia. Emerging evidence from several countries suggests increasing incidence in people aged <50 years.Methods: We assessed colon and rectal cancer incidence trends in people aged 20þ in Australia from 1982 to 2014. We used data on 375,008 incident cases (248,162 colon and 126,846 rectal). We quantified the annual percentage change (APC) in rates by age group using Joinpoint regression.Results: For people aged <50 years, colon cancer rates increased from the mid-2000s, with the increase in APCs ranging from 1.7% to 9.3% per annum (depending on specific age group); rectal cancer rates increased from the early 1990s, with APCs ranging from 0.9% to 7.1% per annum. For people aged 50 to 69 years, colon and rectal cancer rates decreased from the mid-1990s, with the decrease in APCs in specific age groups ranging from 0.8% to 4.8% per annum (except for colon cancer in those ages 65 to 69 years, where similar rate decreases were observed from 2007). An overall reduction in older persons (>70 years) was estimated at 1.9% to 4.9% per annum for colon cancer from 2010 onward and 1.1% to 1.8% per annum in rectal cancer from the early 2000s onward.Conclusions: Colon and rectal cancer incidence has increased in people aged <50 years in Australia over the last two decades. However, colon and rectal cancer rates decreased in people aged 50þ, likely due to de facto and organized bowel cancer screening.Impact: Further research is needed to examine the cause of the increase and to quantify the impact of future trends on the cost-effectiveness of population-based screening for those <50 years.

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Section: Discussionsupporting

confidence: 91%

Trends in Colon and Rectal Cancer Incidence in Australia from 1982 to 2014: Analysis of Data on Over 375,000 Cases

Feletto

Lew

et al. 2019

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…A study from the United States showed that the risk of colon and rectal cancer was two‐ (incidence rate ratio (IRR) = 2.40, 95% confidence interval (CI) 1.11 to 5.19) and four times higher (IRR = 4.32, 95% CI 2.19 to 8.51), respectively for those born circa 1990, compared to adults born circa 1950. Similarly, in Western Australia, between 1982 and 2007, a 3.0% annual increase in CRC incidence was observed among adolescents and young adults (15–39 years) . As screening is usually recommended for adults aged 50 to 75, changes in incidence in this group is most likely not impacted by screening.…”

Section: Discussionmentioning

confidence: 99%

“…As screening is usually recommended for adults aged 50 to 75, changes in incidence in this group is most likely not impacted by screening. Possible explanations are changes in the prevalence of risk factors such as increasing body weight and lower physical activity …”

Section: Discussionmentioning

confidence: 99%

“…Similarly, in Western Australia, between 1982 and 2007, a 3.0% annual increase in CRC incidence was observed among adolescents and young adults (15-39 years). 44 As screening is usually recommended for adults aged 50 to 75, changes in incidence in this group is most likely not impacted by screening. Possible explanations are changes in the prevalence of risk factors such as increasing body weight and lower physical activity.…”

Section: Discussionmentioning

confidence: 99%

“…Possible explanations are changes in the prevalence of risk factors such as increasing body weight and lower physical activity. 43,44 Advances in treatment options and regimens differ extensively among countries, which may also explain lower CRC mortality rates in some countries. Adjuvant chemotherapy is recommended for patients with more advanced stages of colon cancer, and is associated with an approximate reduction of 30% in the risk of disease recurrence, and a 22-32% reduction in mortality.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Global trends in colorectal cancer mortality: projections to the year 2035

Araghi

Soerjomataram

Jenkins

et al. 2019

Intl Journal of Cancer

423

274

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Colorectal cancer (CRC) is the third most common cancer worldwide and the fourth most common cause of cancer death. Predictions of the future burden of the disease inform health planners and raise awareness of the need for cancer control action. Data from the World Health Organization (WHO) mortality database for 1989–2016 were used to project colon and rectal cancer mortality rates and number of deaths in 42 countries up to the year 2035, using age‐period‐cohort (APC) modelling. Mortality rates for colon cancer are predicted to continue decreasing in the majority of included countries from Asia, Europe, North America and Oceania, except Latin America and Caribbean countries. Mortality rates from rectal cancer in general followed those of colon cancer, however rates are predicted to increase substantially in Costa Rica (+73.6%), Australia (+59.2%), United States (+27.8%), Ireland (+24.2%) and Canada (+24.1%). Despite heterogeneous trends in rates, the number of deaths is expected to rise in all countries for both colon and rectal cancer by 60.0% and 71.5% until 2035, respectively, due to population growth and ageing. Reductions in colon and rectal cancer mortality rates are probably due to better accessibility to early detection services and improved specialized care. The expected increase in rectal cancer mortality rates in some countries is worrisome and warrants further investigations.

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Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer

Demb,

Kolb,

Dounel

et al. 2024

JAMA Netw Open

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ImportanceEarly-onset colorectal cancer (EOCRC), defined as a diagnosis at younger than age 50 years, is increasing, and so-called red flag signs and symptoms among these individuals are often missed, leading to diagnostic delays. Improved recognition of presenting signs and symptoms associated with EOCRC could facilitate more timely diagnosis and impact clinical outcomes.ObjectiveTo report the frequency of presenting red flag signs and symptoms among individuals with EOCRC, to examine their association with EOCRC risk, and to measure variation in time to diagnosis from sign or symptom presentation.Data SourcesPubMed/MEDLINE, Embase, CINAHL, and Web of Science were searched from database inception through May 2023.Study SelectionStudies that reported on sign and symptom presentation or time from sign and symptom presentation to diagnosis for patients younger than age 50 years diagnosed with nonhereditary CRC were included.Data Extraction and SynthesisData extraction and quality assessment were performed independently in duplicate for all included studies using Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. Joanna Briggs Institute Critical Appraisal tools were used to measure risk of bias. Data on frequency of signs and symptoms were pooled using a random-effects model.Main Outcomes and MeasuresOutcomes of interest were pooled proportions of signs and symptoms in patients with EOCRC, estimates for association of signs and symptoms with EOCRC risk, and time from sign or symptom presentation to EOCRC diagnosis.ResultsOf the 12 859 unique articles initially retrieved, 81 studies with 24 908 126 patients younger than 50 years were included. The most common presenting signs and symptoms, reported by 78 included studies, were hematochezia (pooled prevalence, 45% [95% CI, 40%-50%]), abdominal pain (pooled prevalence, 40% [95% CI, 35%-45%]), and altered bowel habits (pooled prevalence, 27% [95% CI, 22%-33%]). Hematochezia (estimate range, 5.2-54.0), abdominal pain (estimate range, 1.3-6.0), and anemia (estimate range, 2.1-10.8) were associated with higher EOCRC likelihood. Time from signs and symptoms presentation to EOCRC diagnosis was a mean (range) of 6.4 (1.8-13.7) months (23 studies) and a median (range) of 4 (2.0-8.7) months (16 studies).Conclusions and RelevanceIn this systematic review and meta-analysis of patients with EOCRC, nearly half of individuals presented with hematochezia and abdominal pain and one-quarter with altered bowel habits. Hematochezia was associated with at least 5-fold increased EOCRC risk. Delays in diagnosis of 4 to 6 months were common. These findings highlight the need to identify concerning EOCRC signs and symptoms and complete timely diagnostic workup, particularly for individuals without an alternative diagnosis or sign or symptom resolution.

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Increasing Incidence of Colorectal Cancer in Adolescents and Young Adults Aged 15–39 Years in Western Australia 1982–2007: Examination of Colonoscopy History

Cited by 71 publications

References 39 publications

Trends in Colon and Rectal Cancer Incidence in Australia from 1982 to 2014: Analysis of Data on Over 375,000 Cases

Trends in Colon and Rectal Cancer Incidence in Australia from 1982 to 2014: Analysis of Data on Over 375,000 Cases

Global trends in colorectal cancer mortality: projections to the year 2035

Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer

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