Demographic trends in the incidence of young-onset colorectal cancer: a population-based study. Issue 5 (9th March 2020)

• Record Type: Journal Article
• Authors: Chambers, A C; Dixon, S W; White, P; Williams, A C; Thomas, M G; Messenger, D E
• Is Part Of: British journal of surgery. Volume 107:Issue 5(2020)
• Page Start: 595
• Page End: 605
• Publication Date: 2020-03-09
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.11486
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Background: Evidence is emerging that the incidence of colorectal cancer is increasing in young adults, but the descriptive epidemiology required to better understand these trends is currently lacking. Methods: A population-based cohort study was carried out including all adults aged 20–49 years diagnosed with colorectal cancer in England between 1974 and 2015. Data were extracted from the National Cancer Registration and Analysis Service database using ICD-9/10 codes for colorectal cancer. Temporal trends in age-specific incidence rates according to sex, anatomical subsite, index of multiple deprivation quintile and geographical region were analysed using Joinpoint regression. Results: A total of 56 134 new diagnoses of colorectal cancer were analysed. The most sustained increase in incidence rate was in the group aged 20–29 years, which was mainly driven by a rise in distal tumours. The magnitude of incident rate increases was similar in both sexes and across Index of Multiple Deprivation quintiles, although the most pronounced increases in incidence occurred in the southern regions of England. Conclusion: Colorectal cancer should no longer be considered a disease of older people. Changes in incidence rates should be used to inform future screening policy, preventative strategies and research agendas, as well as increasing public understanding that younger people need to be aware of the symptoms of colorectal cancer. Graphical Abstract: The incidence rate of colorectal cancer in young adults is increasing. Detailed epidemiological analysis of these trends is necessary to understand them better. This article shows that the rising incidence in young adults is being driven by distal colorectal tumours, with the magnitude of trends greatest in southern regions of England, independent of sex or socioeconomic status. Incidence increasing in young adults