John Virostko1,2,3, Anna Capasso2,3, Thomas E Yankeelov1,2,3,4,5, Boone Goodgame2,3,6,7. 1. Department of Diagnostic Medicine, University of Texas at Austin, Austin, Texas. 2. Livestrong Cancer Institutes, University of Texas at Austin, Austin, Texas. 3. Department of Oncology, University of Texas at Austin, Austin, Texas. 4. Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas. 5. Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, Texas. 6. Department of Internal Medicine, University of Texas at Austin, Austin, Texas. 7. Ascension Seton, Austin, Texas.
Abstract
BACKGROUND: The incidence of colorectal cancer (CRC) in adults younger than 50 years has increased in the United States over the past decades according to Surveillance, Epidemiology, and End Results data. National guidelines conflict over beginning screening at the age of 45 or 50 years. METHODS: This was a retrospective study of National Cancer Data Base data from 2004 to 2015. The Cochran-Armitage test for trend was used to assess changes in the proportion of cases diagnosed at an age younger than 50 years. RESULTS: This study identified 130,165 patients diagnosed at an age younger than 50 years and 1,055,598 patients diagnosed at the age of 50 years or older. The proportion of the total number of patients diagnosed with CRC at an age younger than 50 years rose (12.2% in 2015 vs 10.0% in 2004; P < .0001). Younger adults presented with more advanced disease (stage III/IV; 51.6% vs 40.0% of those 50 years old or older). Among men, diagnosis at ages younger than 50 years rose only in non-Hispanic whites (P < .0001), whereas among women, Hispanic and non-Hispanic whites had increases in younger diagnoses over time (P < .05). All income quartiles had a proportional increase in younger adults over time (P < .001), with the highest income quartile having the highest proportion of younger cases. The proportion of younger onset CRC cases rose in urban areas (P < .001) but did not rise in rural areas. CONCLUSIONS: The proportion of persons diagnosed with CRC at an age younger than 50 years in the United States has continued to increase over the past decade, and younger adults present with more advanced disease. These data should be considered in the ongoing discussion of screening guidelines.
BACKGROUND: The incidence of colorectal cancer (CRC) in adults younger than 50 years has increased in the United States over the past decades according to Surveillance, Epidemiology, and End Results data. National guidelines conflict over beginning screening at the age of 45 or 50 years. METHODS: This was a retrospective study of National Cancer Data Base data from 2004 to 2015. The Cochran-Armitage test for trend was used to assess changes in the proportion of cases diagnosed at an age younger than 50 years. RESULTS: This study identified 130,165 patients diagnosed at an age younger than 50 years and 1,055,598 patients diagnosed at the age of 50 years or older. The proportion of the total number of patients diagnosed with CRC at an age younger than 50 years rose (12.2% in 2015 vs 10.0% in 2004; P < .0001). Younger adults presented with more advanced disease (stage III/IV; 51.6% vs 40.0% of those 50 years old or older). Among men, diagnosis at ages younger than 50 years rose only in non-Hispanic whites (P < .0001), whereas among women, Hispanic and non-Hispanic whites had increases in younger diagnoses over time (P < .05). All income quartiles had a proportional increase in younger adults over time (P < .001), with the highest income quartile having the highest proportion of younger cases. The proportion of younger onset CRC cases rose in urban areas (P < .001) but did not rise in rural areas. CONCLUSIONS: The proportion of persons diagnosed with CRC at an age younger than 50 years in the United States has continued to increase over the past decade, and younger adults present with more advanced disease. These data should be considered in the ongoing discussion of screening guidelines.
Authors: Alan P Venook; Donna Niedzwiecki; Heinz-Josef Lenz; Federico Innocenti; Briant Fruth; Jeffrey A Meyerhardt; Deborah Schrag; Claire Greene; Bert H O'Neil; James Norman Atkins; Scott Berry; Blase N Polite; Eileen M O'Reilly; Richard M Goldberg; Howard S Hochster; Richard L Schilsky; Monica M Bertagnolli; Anthony B El-Khoueiry; Peter Watson; Al B Benson; Daniel L Mulkerin; Robert J Mayer; Charles Blanke Journal: JAMA Date: 2017-06-20 Impact factor: 56.272
Authors: Donald M Davis; Jorge E Marcet; Jared C Frattini; Andrew D Prather; James J L Mateka; Valentine N Nfonsam Journal: J Am Coll Surg Date: 2011-07-07 Impact factor: 6.113
Authors: Xiaocheng Wu; Vilma Cokkinides; Vivien W Chen; Marion Nadel; Yuan Ren; Jim Martin; Gary L Ellison Journal: Cancer Date: 2006-09-01 Impact factor: 6.860
Authors: Brenda K Edwards; Elizabeth Ward; Betsy A Kohler; Christie Eheman; Ann G Zauber; Robert N Anderson; Ahmedin Jemal; Maria J Schymura; Iris Lansdorp-Vogelaar; Laura C Seeff; Marjolein van Ballegooijen; S Luuk Goede; Lynn A G Ries Journal: Cancer Date: 2010-02-01 Impact factor: 6.860
Authors: Dung T Le; Jennifer N Uram; Hao Wang; Bjarne R Bartlett; Holly Kemberling; Aleksandra D Eyring; Andrew D Skora; Brandon S Luber; Nilofer S Azad; Dan Laheru; Barbara Biedrzycki; Ross C Donehower; Atif Zaheer; George A Fisher; Todd S Crocenzi; James J Lee; Steven M Duffy; Richard M Goldberg; Albert de la Chapelle; Minori Koshiji; Feriyl Bhaijee; Thomas Huebner; Ralph H Hruban; Laura D Wood; Nathan Cuka; Drew M Pardoll; Nickolas Papadopoulos; Kenneth W Kinzler; Shibin Zhou; Toby C Cornish; Janis M Taube; Robert A Anders; James R Eshleman; Bert Vogelstein; Luis A Diaz Journal: N Engl J Med Date: 2015-05-30 Impact factor: 91.245
Authors: Rebecca L Siegel; Stacey A Fedewa; William F Anderson; Kimberly D Miller; Jiemin Ma; Philip S Rosenberg; Ahmedin Jemal Journal: J Natl Cancer Inst Date: 2017-08-01 Impact factor: 13.506
Authors: Douglas K Rex; C Richard Boland; Jason A Dominitz; Francis M Giardiello; David A Johnson; Tonya Kaltenbach; Theodore R Levin; David Lieberman; Douglas J Robertson Journal: Gastrointest Endosc Date: 2017-06-06 Impact factor: 9.427
Authors: Ann Chao; Michael J Thun; Cari J Connell; Marjorie L McCullough; Eric J Jacobs; W Dana Flanders; Carmen Rodriguez; Rashmi Sinha; Eugenia E Calle Journal: JAMA Date: 2005-01-12 Impact factor: 56.272
Authors: Harland Austin; S Jane Henley; Jessica King; Lisa C Richardson; Christie Eheman Journal: Cancer Causes Control Date: 2013-11-19 Impact factor: 2.506
Authors: Scott Sherrill-Mix; Michelle Yang; Grace M Aldrovandi; Jason M Brenchley; Frederic D Bushman; Ronald G Collman; Satya Dandekar; Nichole R Klatt; Laurel A Lagenaur; Alan L Landay; Roger Paredes; Gilda Tachedjian; Jim A Turpin; Sergio Serrano-Villar; Catherine A Lozupone; Mimi Ghosh Journal: AIDS Res Hum Retroviruses Date: 2022-01-25 Impact factor: 2.205
Authors: Nicolette Taku; Y Nancy Yi-Qian; George J Chang; Ethan B Ludmir; Kanwal Pratap Singh Raghav; Miguel A Rodriguez-Bigas; Emma Brey Holliday; Grace L Smith; Bruce D Minsky; Michael J Overman; Craig Messick; David Boyce-Fappiano; Albert C Koong; John Michael Skibber; Eugene Jon Koay; Arvind Dasari; Cullen M Taniguchi; Brian K Bednarski; Van K Morris; Scott Kopetz; Prajnan Das Journal: Clin Colorectal Cancer Date: 2021-10-09 Impact factor: 4.481
Authors: Jada C Domingue; Julia L Drewes; Christian A Merlo; Franck Housseau; Cynthia L Sears Journal: Mucosal Immunol Date: 2020-02-28 Impact factor: 7.313