Rising Proportion of Young Individuals With Rectal and Colon Cancer

Abstract

We noticed an increased number of patients diagnosed with colorectal cancer (CRC) in their 20s, 30s, and 40s. We analyzed all CRC patients aged < 50 at our institutions from 1972 to 2017 and found increasing trends as well as a propensity for more distal location-findings that are hypothesis generating, given the embryologic origin of these tumors. This finding may have implications for screening guidelines. Background: Recent trends have identified increasing number of young individuals with rectal and colon cancers. These individuals, who are younger than 50 years old, in most instances would not meet screening guidelines. We aimed to report the characteristics and trend of the rising proportion of young individuals being diagnosed with rectal and colon cancers at our institutions. Patients and Methods: This study included 3381 rectal and colon cancer patients from the Mayo Clinic cancer registry from 1972 to 2017 who were diagnosed with rectal or colon cancer and who were < 50 years old. Patient and cancer characteristics are described. The Cochran-Armitage trend test was used to see if the change in percentage diagnosed at age < 50 years had a significant trend over the years. A linear regression model was fit to estimate the percentage change per year when the trend was approximately linear. Results: The percentage of patients diagnosed with rectal or colon cancer in different age categories over the years showed a rising trend for individuals aged < 50. Most of these tumors were distal (rectum, left-sided colon, and rightsided colon were 49.8%, 28.8%, and 21.4%, respectively). This was more so for patients < 50 diagnosed with rectal cancer, which showed a linear increase at a rate of 0.26% per year (P < .001). Conclusion: Our study affirms the rising proportion of colorectal cancers found in young individuals, with a linear ongoing rise of rectal cancers in particular. This may have implications for the current screening recommendations for colorectal cancers, which are already being revised.

Colorectal cancer under 20 years old: a retrospective analysis from three tertiary hospitals

“…We have witnessed an overall trend of decreased incidence of CRC over the past few decades as a result of using colonoscopy and other screening modalities in the older population (Connell et al 2017). However, CRC incidence in young individuals is steadily rising (Kasi et al 2019). AYA CRCs present with more advanced stage, poorer cell differentiation, and higher prevalence of signet ring cell histology, and the primary tumors are commonly located in the left side of the colon at diagnosis.…”

Identification of NEO1 as a prognostic biomarker and its effects on the progression of colorectal cancer

“…The morbidity of colorectal cancer (CRC) is rising sharply in those who are younger than 50 years old. What worries us more is that CRC has ranked the first causes of cancer death in men age 20–49 during 2012 to 2016 [ 1 – 3 ]. Although the 5-year survival rate for patients with CRC has ascended to about 65%, the rate declines to 12% of patients diagnosed with stage IV, emphasizing the urgently need to identify early predictive and prognostic biomarkers [ 4 , 5 ].…”

Enhancement of Deep Learning in Image Classification Performance Using Xception with the Swish Activation Function for Colorectal Polyp Preliminary Screening

“…Colorectal cancer (CRC) is a form of cancer that occurs globally and is one of the most common forms of cancer among both men and women in terms of the causes of human mortality [1,2]. Recently, reports have identified that the number of people with CRC younger than 50 years old is increasing, which means cancer screening is a more essential process than ever [3,4]. Cancer features unlimited division and appears in living anomalous cells in various organs, as well as when abnormal cells appear and grow in the colon, which is the case with CRC [4].…”