Rise in Early-Onset CRC Extends Beyond High-Income Countries

TOPLINE:

The increase in incidence of early-onset colorectal cancer (CRC) is no longer confined to high-income nations. A recent study found that rates are also rising in Latin America, Asia, and Eastern Europe. Of the 50 countries analyzed through 2017, 27 showed a rising incidence of the disease among people younger than 50 years.

METHODOLOGY:

• The primary objective was to examine CRC incidence trends in younger adults compared with older adults by analyzing data from 50 countries and territories including a dozen countries not previously explored, such as Argentina, Belarus, Chile, Ecuador, Kuwait, Qatar, Thailand, and Uganda.
• The analysis included CRC incidence data from the World Health Organization–International Agency for Research on Cancer Incidence in the Five Continents Plus database, which covered 27 of the 50 countries and territories. Data from the remaining 23 were pulled from one or more subnational population-based cancer registries.
• Researchers examined age-standardized incidence rates per 100,000 person-years for early-onset (aged 25-49 years) and late-onset (aged 50-74 years) CRC diagnosed between 1943-2003 and 2015-17.

TAKEAWAY:

• The highest rates of early-onset CRC incidence were found in Australia (16.5 per 100,000 person-years), Puerto Rico (15.2 per 100,000 person-years), New Zealand (14.8 per 100,000 person-years), and the United States (14.8 per 100,000 person-years).
• Among the 27 countries with increasing early-onset CRC rates, those with the steepest rises were observed in New Zealand with an average annual percentage change of 3.97% followed closely by Chile (3.96%) and Puerto Rico (3.81%). The other 23 countries showed stable incidence rates of early-onset disease.
• In 14 of the 27 countries or territories including Australia, Canada, and the United States, the increase was exclusive to early-onset disease, whereas older adults showed stable or decreasing trends.
• The sex-specific analysis revealed a faster increase among men in eight countries, including Chile and Puerto Rico, whereas six countries, including England and Norway, saw faster increases among women.

IN PRACTICE:

“The increase in early-onset colorectal cancer, previously seen predominately in high-income western countries, has now been documented in various economies and regions worldwide, marking it as a global phenomenon,” the study authors wrote. “The findings underscore the need for intensified efforts to identify factors driving these trends and increase awareness to help facilitate early detection.” 

The authors added that “educational efforts to increase awareness of the increase in the incidence of early-onset colorectal cancer and its unique symptoms, especially among primary care providers, would have far reaching effects in reducing delayed diagnoses and mortality.”

SOURCE:

The study, led by Hyuna Sung, PhD, American Cancer Society in Atlanta, was published online in The Lancet Oncology.

LIMITATIONS:

According to the authors, the study was limited by underrepresentation of countries in Africa, Asia, and small islands where ongoing socioeconomic transitions might increase CRC rates.

DISCLOSURES:

This study received funding from the Intramural Research Program of the American Cancer Society, Cancer Grand Challenges, and National Institutes of Health. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.