National Trends in Colorectal Cancer Incidence Among Older and Younger Adults in Canada

Brenner, Darren R.; Heer, Emily; Sutherland, Robert L.; Ruan, Yibing; Tinmouth, Jill; Heitman, Steven J.; Hilsden, Robert J.

doi:10.1001/jamanetworkopen.2019.8090

Cited by 90 publications

(84 citation statements)

References 15 publications

(32 reference statements)

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“…Cancer is generally considered a disease of aging, with only approximately 10% of all new cases in Canada being diagnosed before the age of 50 years 1 . However, recent reports have shown that colorectal cancer is increasing disproportionately in young adults, with successively younger generations at higher risk 2,3 . Other cancers, including multiple myeloma and cancers of the uterine corpus, gallbladder, kidney, and pancreas, have exhibited similar increases among young adults 2 .…”

Section: Introductionmentioning

confidence: 99%

Emerging cancer incidence trends in Canada: The growing burden of young adult cancers

Heer

Harper

Sung

et al. 2020

Cancer

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BACKGROUND: Recent studies have identified increases in cancer incidence among younger adults for some cancers. This study examined incidence trends for 28 cancers in Canada by age and birth cohort from 1983 to 2012. METHODS: Canadian incidence data for 20 to 84 year-olds were obtained from the Cancer Incidence in Five Continents Plus database. Age-period-cohort modeling was used to estimate the average annual percentage changes (AAPCs) and incidence rate ratios (IRRs) for 10-year birth cohorts (reference cohort, 1943) for 28 cancer types. RESULTS: Incidence increased for 13 cancer sites among adults younger than 50 years (1983-2012), with the largest increase occurring for rectal cancer (

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Section: Introductionmentioning

confidence: 99%

Emerging cancer incidence trends in Canada: The growing burden of young adult cancers

Heer

Harper

Sung

et al. 2020

Cancer

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“…(21) Simultaneously, an increase in CRC rates among younger adults <50 years of age is reported. (1,2,4) Regular screening for CRC is recommended by the U.S. Preventive Services Task Force (USPSTF) beginning at age 50. (22) Due to the large‐scale screening programs in these patients >50 years of age with removal of precancerous polyps during colonoscopy and earlier detection of CRC, the incidence and mortality of CRC has declined.…”

Section: Systemic Metabolic Dysfunction and Its Link To Colorectal Camentioning

confidence: 99%

“…Colorectal cancer (CRC) is one of the most common causes of cancer‐related death in the USA and its incidence among young adults has increased over the last several decades. (1‐4) Simultaneously, the proportion of overweight and obese children and adolescents is rising, suggesting an association between metabolic dysfunction and carcinogenic mechanisms. (4‐7) A direct association between obesity and early‐onset CRC was found among young women as part of the The Nurses' Health Study II.…”

Section: Introductionmentioning

confidence: 99%

Metabolic dysfunction and early‐onset colorectal cancer – how macrophages build the bridge

et al. 2020

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Background The incidence of colorectal cancer (CRC) among patients <50 years of age has increased dramatically over the last decades. At the same time, the growing proportion of obese children and adolescents and the increasing proportion of young and obese patients with CRC suggests an association between metabolic dysfunction and carcinogenesis. Tumor‐associated macrophages (TAMs) are able to orchestrate tumor promoting and suppressing mechanisms in CRC. The aim of this review was to discuss the different roles of TAMs in CRC and their phenotype‐specific metabolic pathways to identify potential new targets for CRC treatment. Methods A literature search was performed using PubMed, Cochrane and Embase to identify studies on TAMs and their metabolism in CRC. The following search terms were used in various combinations: (obesity OR adiposity OR obese) AND (macrophage OR polarization OR macrophage metabolism) AND ((colon cancer*) OR (colon carcinoma) OR (colonic tumor*) OR (colonic neoplasm[MeSH]) OR (rectal cancer*) OR (rectal carcinoma) OR (rectal tumor*) OR (rectal neoplasm[MeSH]) OR (colorectal cancer*) OR (colorectal carcinoma) OR (colorectal tumor*) OR (colorectal neoplasm[MeSH])). Studies including data on the phenotype and metabolism of TAMs in CRC were analyzed. Results Evidence for the prognostic utility of macrophage markers in CRC is currently evolving, with a particular role of stage‐dependent cellular metabolism profiles of TAMs. Itaconate is one of the metabolites produced by proinflammatory subtypes of TAMs and it is known to have tumor promoting effects. Metabolic pathways that are involved in macrophage activation and reprogramming play a role in a chronic inflammatory setting, consequently affecting the onset and development of CRC. Conclusions Tumor‐promoting metabolites, such as itaconate, are directly regulating these mechanisms, thereby triggering carcinogenesis. Metabolic reprogramming in TAMs can build a bridge between metabolic dysfunction and the onset and progression of CRC through inflammatory pathways, particularly in younger patients with early‐onset CRC.

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“…[1] Also a recent trend is the increased risk of CRC among individuals less than 50 years, with an APCi of 4.45% for women less than 50 years since 2010 and APCi of 3.74% for men less than 50 years from 2006 through 2015. [2] The physical (e.g. pain, disability) [3,4] and psycho-social (e.g.…”

Section: Introductionmentioning

confidence: 99%

Patients’ Perspectives on Health Information Seeking Throughout the Colorectal Cancer Experience: A Qualitative Study

Dau¹,

Breau²,

McTaggart-Cowan³

et al. 2020

Preprint

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BACKGROUND: With limited research on how patients with colorectal cancer (CRC) access and apply health information, our objective was to explore patients’ perspectives on health information seeking.METHODS: We invited participants from Canada, 18 years of age or over, to participate. Semi-structured, open-ended interviews were conducted over the telephone and transcribed verbatim. Transcripts were analyzed using an interpretive description approach.RESULTS: Among 34 participants with CRC, 18 were females (52.9%). Twenty (58.8%) were diagnosed with CRC on or after the age of 50 years and 14 (41.2%) before the age of 50 years. Sixteen (47.1%) were diagnosed with colon cancer, 12 (35.3%) with rectal cancer and 6 (17.7%) with cancer at both sites. We identified three themes that reflect participants’ health information seeking in terms of perspectives on sources primarily sought. These themes and specific sub-themes that suggest areas for improvement are: 1) perceived expectations of physicians – which included sub-themes of varied interactions and relationships with physicians and feeling abandoned after active treatment; 2) importance of personal and social connections – which included the sub-theme of experiencing gaps with current in-person cancer support groups; and 3) use of the Internet for information – which included the sub-theme of using credible Internet sources.CONCLUSION: Our study identified gaps with respect to availability, access to, or knowledge of resources for CRC. Understanding how individuals with CRC seek health information have implications for informing interactions with patients and developing resources across the continuum of CRC care.

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National Trends in Colorectal Cancer Incidence Among Older and Younger Adults in Canada

Cited by 90 publications

References 15 publications

Emerging cancer incidence trends in Canada: The growing burden of young adult cancers

Emerging cancer incidence trends in Canada: The growing burden of young adult cancers

Metabolic dysfunction and early‐onset colorectal cancer – how macrophages build the bridge

Patients’ Perspectives on Health Information Seeking Throughout the Colorectal Cancer Experience: A Qualitative Study

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