The impact of young adult colorectal cancer: incidence and trends in Colorado

Abstract

Practice pointsr The absolute incidence of colorectal cancer continues to fall in the state of Colorado. r However, the incidence is rising in individuals under the age of 50, particularly males. r There is a trend toward later stage disease at diagnosis in young adults. r The overall cause of rising incidence in young adults is still unknown, but there are multiple known risk factors that may be contributing to this trend, including genetic, environmental, or lifestyle-based. r Further analysis is warranted into potential biologic difference between tumors in younger and older patients.Aim:Far less is known about colorectal cancer (CRC) incidence in individuals under the age of 50. This study examined CRC incidence in order to better understand the changing CRC population. Methods: This study analyzed 39,525 CRC cases from the Colorado Central Cancer Registry from 1992 through 2013. Ageadjusted incidence, observed and relative 5-year survival, and estimated annual percentage change was analyzed. Results: Age-adjusted rates averaging 1.7% per year were observed in the under-50 population, while falling on average 4.3% per year (p < 0.05) in the over-50 population. Average-adjusted incidence rose in males under 50 by 2.7% per year (p < 0.05). Conclusion: The absolute incidence of CRC continues to fall in Colorado, however incidence is rising in individuals under 50, particularly males.

Changes in lipids composition and metabolism in colorectal cancer: a review

“…Despite a decrease in mortality, CRC still remains a serious public health burden [26]. A growing number of CRCs are diagnosed in patients younger than 50 years [220, 221]. The reason for this alarming tendency is yet to be elucidated, but it may be a consequence of greater exposure to environmental factors, lesser physical activity and unfavorable dietary changes.…”

Comprehensive Genomic Landscapes in Early and Later Onset Colorectal Cancer

“…Patients with early-onset colorectal cancer present with unique challenges, as younger patients may have young children, early career goals, financial toxicity, and concerns such as fertility preservation that are not as prevalent in older patients (11). Clinically, patients with early-onset colorectal cancer may present differently than older-onset colorectal cancer with prolonged hematochezia, multiple office visits, and delayed time from onset of symptoms to diagnosis (12). These issues emphasize the importance of specifically investigating underlying biological differences in younger versus older patients with colorectal cancer (9).…”

“…Although etiologies for the increase seen in young adults are yet to be fully elucidated, environmental factors may contribute including changes in lifestyle and dietary patterns. There is evidence for an increased prevalence of hereditary risk factors for colorectal cancer including familial adenomatous polyposis (FAP) and Lynch syndrome in early-onset colorectal cancer cases, but these hereditary risk factors do not fully account for the increase seen in younger patients (12)(13)(14). Approximately 80% of patients with FAP harbor truncating germline mutations in the Adenomatous Polyposis Coli (APC) tumor suppressor gene, with identified mutations including R564X, R876X, Q1045X, 3927-3931delAAAGA, D1822V, and 2601delGA, R923X (15).…”

The experiences of colorectal cancer patients in postoperative recovery: integrative review

“…Colorectal cancer is a common cancer of the gastrointestinal tract and is a major cause of global deaths. Currently, the diagnosis of colorectal cancer is increasing among younger populations in Asia and the West [1,2]. In the USA, according to data from 1974 to 2013, the number of patients with colorectal cancer increased each year and the incidence rate is now very high among the elderly [3].…”