Racial Disparities and Sex Differences in Early- and Late-Onset Colorectal Cancer Incidence, 2001–2018

Abstract

BackgroundColorectal cancer (CRC) incidence rates have increased in younger individuals worldwide. We examined the most recent early- and late-onset CRC rates for the US.MethodsAge-standardized incidence rates (ASIR, per 100,000) of CRC were calculated using the US Cancer Statistics Database’s high-quality population-based cancer registry data from the entire US population. Results were cross-classified by age (20-49 [early-onset] and 50-74 years [late-onset]), race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, American Indian/Alaskan Native, Asian/Pacific Islander), sex, anatomic location (proximal, distal, rectal), and histology (adenocarcinoma, neuroendocrine).ResultsDuring 2001 through 2018, early-onset CRC rates significantly increased among American Indians/Alaskan Natives, Hispanics, and Whites. Compared to Whites, early-onset CRC rates are now 21% higher in American Indians/Alaskan Natives and 6% higher in Blacks. Rates of early-onset colorectal neuroendocrine tumors have increased in Whites, Blacks, and Hispanics; early-onset colorectal neuroendocrine tumor rates are 2-times higher in Blacks compared to Whites. Late-onset colorectal adenocarcinoma rates are decreasing, while late-onset colorectal neuroendocrine tumor rates are increasing, in all racial/ethnic groups. Late-onset CRC rates remain 29% higher in Blacks and 15% higher in American Indians/Alaskan Natives compared to Whites. Overall, CRC incidence was higher in men than women, but incidence of early-onset distal colon cancer was higher in women.ConclusionsThe early-onset CRC disparity between Blacks and Whites has decreased, due to increasing rates in Whites—rates in Blacks have remained stable. However, rates of colorectal neuroendocrine tumors are increasing in Blacks. Blacks and American Indians/Alaskan Natives have the highest rates of both early- and late-onset CRC.ImpactOngoing prevention efforts must ensure access to and uptake of CRC screening for Blacks and American Indians/Alaskan Natives.

Molecular and Sociodemographic Colorectal Cancer Disparities in Latinos Living in Puerto Rico

“…A higher number of women was diagnosed with early-onset CRC compared to men. This is in contrast to a large nationwide study reporting that men have 16% higher incidence rates of early-onset CRC [ 59 ]. As most early-onset CRC cases in our study were diagnosed at early stages, a possible reason that may in part explain this disparity is that women have been reported to seek more healthcare compared to men [ 60 ].…”

“…Significantly lower levels of European admixture and higher levels of Amerindian admixture were observed among individuals with early-onset CRC. Hispanics vary in their percentages of admixture of ancestral population and in the fact that they are the racial/ethnic subgroup in the U.S. with the highest increase in annual incidence rates from 2013–2018 [ 59 ]. Thus, larger studies evaluating the association between genetic admixture and early-onset CRC are needed to determine if this is a factor that could be used to identify individuals at higher risk of developing CRC at an early age and to develop tailored screening guidelines according to admixture.…”

Diet as a Risk Factor for Early-Onset Colorectal Adenoma and Carcinoma: A Systematic Review

“…Though multiple countries were included across the studies, most participants were white and often female, reducing the generalizability of these results. It appears EOCRC is similar between males and females, therefore the predominant inclusion of females is not a limitation of the results ( 7 , 52 , 53 ). The possibility of residual confounding factors cannot be ruled out in the observational studies due to the nature of the studies.…”

Pathological Evaluation of Rectal Cancer Specimens Using Micro-Computed Tomography

“…Colorectal cancer is the third most commonly diagnosed cancer among men and women, with an estimated 1.9 million new cases, and the second leading cause of cancer-related deaths, with an estimated 0.9 million deaths worldwide in 2020 [ 1 ]. Rectal cancer accounts for nearly 30% of colorectal cancer cases [ 2 , 3 ], and 40% of the patients with rectal cancer are diagnosed with locally advanced disease [ 4 , 5 ]. Although the 5 year overall survival is slightly higher in patients with rectal cancers than in those with colon cancers [ 4 ], the treatment of rectal cancer is more challenging because it affects the anal sphincter, bladder, and sexual function, and a balanced therapeutic approach to preserve patient quality of life is required [ 6 ].…”