Reasons for the continuing increase in cases of young-onset colorectal cancer (CRC), despite a decline in the overall rate of the disease in recent years, are unclear. These findings were presented at Digestive Disease Week 2016.1
Much has been done to address CRC in persons older than 50 years through greater patient awareness and increased screenings; however, this study’s findings indicate more needs to be done to address the disease in people younger than 50 years, a group not normally considered at risk, reported Elie Sutton, MD, a research fellow at Mt. Sinai West Hospital, New York, New York, and lead author of the study.
“Not only did we find that the rate of colorectal cancer in this group is rising, we also saw that within the group that was diagnosed at a younger age, a higher percentage were diagnosed at later stages of cancer (stage 3 or 4), which is very concerning,” said Sutton.
After examining records from more than 1 million patients with CRC over 10 years, the researchers found that the number of CRC cases decreased by 2.5% in patients age 50 years and older, but increased by 11.4% in patients younger than 50 years. Young-onset cases were more prevalent among non-white patients than late-onset cases (22.1% vs 16.0%). The younger group also had a higher incidence of more advanced cancer than the older group (stage 3, 30.6% vs 25.1%; stage 4, 25.6% vs 18.2%, respectively).
Studies of CRC from approximately 5 years ago found a similar trend toward young-onset disease, Sutton said. “Between the time of the previous research and our study, we still have not adequately addressed the risk of colorectal cancer in people [younger than 50 years]. It’s critical that we reverse this trend so that we are able to reduce, and hopefully eliminate, it in all populations, regardless of age.”
Although these findings show that incidence of CRC is increasing in people younger than 50 years, Sutton noted that the overwhelming majority of CRC cases still involve patients older than 50 years.
The researchers conclude that clinicians should maintain a lower threshold for colonoscopy in patients with bleeding or other colorectal complaints, and they should be more vigilant about detecting symptoms in younger patients.
1. Sutton E, Bellini G, Lee D, et al. An update on young-onset colorectal cancer, an NCDB analysis. Presentation at: Digestive Disease Week 2016; May 22-24, 2016; San Diego, CA.