Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015. Issue 21 (22nd July 2019)

• Record Type: Journal Article
• Authors: Virostko, John; Capasso, Anna; Yankeelov, Thomas E.; Goodgame, Boone
• Is Part Of: Cancer. Volume 125:Issue 21(2019)
• Page Start: 3828
• Page End: 3835
• Publication Date: 2019-07-22
• Subjects: age -- colorectal cancer -- diagnosis -- National Cancer Data Base (NCDB); Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.32347
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : Background: The incidence of colorectal cancer (CRC) in adults younger than 50 years has increased in the United States over the past decades according to Surveillance, Epidemiology, and End Results data. National guidelines conflict over beginning screening at the age of 45 or 50 years. Methods: This was a retrospective study of National Cancer Data Base data from 2004 to 2015. The Cochran‐Armitage test for trend was used to assess changes in the proportion of cases diagnosed at an age younger than 50 years. Results: This study identified 130, 165 patients diagnosed at an age younger than 50 years and 1, 055, 598 patients diagnosed at the age of 50 years or older. The proportion of the total number of patients diagnosed with CRC at an age younger than 50 years rose (12.2% in 2015 vs 10.0% in 2004; P < .0001). Younger adults presented with more advanced disease (stage III/IV; 51.6% vs 40.0% of those 50 years old or older). Among men, diagnosis at ages younger than 50 years rose only in non‐Hispanic whites ( P < .0001), whereas among women, Hispanic and non‐Hispanic whites had increases in younger diagnoses over time ( P < .05). All income quartiles had a proportional increase in younger adults over time ( P < .001), with the highest income quartile having the highest proportion of younger cases. The proportion of younger onset CRC cases rose in urban areas ( P < .001) but did not rise in rural areas. Conclusions: The proportion of persons diagnosed with CRC at an age younger than 50 years in the United States has continued to increase over the past decade, and younger adults present with more advanced disease. These data should be considered in the ongoing discussion of screening guidelines. Abstract : The proportion of colorectal cancer cases diagnosed before the age of 50 years increased between 2004 and 2015, confirming that colorectal cancer is an increasing problem among adults younger than 50 years and should be considered in the ongoing debate over the age at which to begin screening. Factors typically associated with better access to health care (private insurance, urban geography, and white race) are associated with rising proportions of earlier onset colon cancer.