ACG: Recent Increase in Incidence of Young-onset Colorectal Cancer

The incidence of young-onset colorectal cancer is increasing, and the disease is more aggressive pathologically. These findings are being presented at the annual meeting of the American College of Gastroenterology, held from Oct. 17 to 22 in Philadelphia.

The incidence of young-onset colorectal cancer (CRC) is increasing, and the disease is more aggressive pathologically. These findings are being presented at the annual meeting of the American College of Gastroenterology, held from Oct. 17 to 22 in Philadelphia.

Xi E. Zheng, MD, from Weill Cornell Medical College in New York City, and colleagues used Surveillance, Epidemiology, and End Results data from 18 registries to examine the incidence and characteristics of young-onset (younger than 50 years) versus old-onset (50 years and older) CRC.

The researchers found that from 2000 to 2011 the annual rate of increase was 1.4% for new cases of young-onset CRC, compared with a 3.1% annual decline in old-onset CRC. The rate of distant disease increased 3% annually, while localized or regional disease increased 1% annually among young-onset CRC. Young-onset CRC was more likely in males versus females (odds ratio, 1.13) and in blacks and Hispanics versus whites (odds ratios, 1.6 and 2.1, respectively). Presentation was more likely at an advanced stage, higher grade, and in left-sided colon or rectum in young-onset disease. Larger tumor size, higher rates of lymph node positivity, perineural invasion, and positive surgical margins were seen for young-onset CRC (all P < 0.001).

"Future research and efforts are ongoing to better understand the biology of young-onset CRC and to improve a CRC screening strategy for the younger patient population," the authors write.