March 16, 2017

Colorectal cancer rates increasing among Gen X, millennials, research finds

Daily Briefing

    Colorectal cancer has risen steadily among young and middle-aged U.S. adults, according to recently released research.

    The findings come amid an overall decline in new cases of colon or rectal cancer fueled largely by declines among people older than 50, who were believed to be most at risk of the disease and therefore most likely to be screened via a colonoscopy.  According to the Los Angeles Times' "Science Now," about 135,000 new cases of colorectal cancer are diagnosed annually in the United States, down from 160,000 a decade ago.

    But the latest data show colon and rectal cancer diagnoses among patients in their 20s, 30s, and 40s have been on the rise.

    Study from the American Cancer Society and National Cancer Institute

    One study published by the American Cancer Society (ACS) and the National Cancer Institute found U.S. residents born in 1990 have double and quadruple the likelihood of being diagnosed with colon and rectal cancer, respectively, at any given point in their lives than a person born in 1950.

    For the study, which was published in the Journal of the National Cancer Institute, researchers reviewed rates of patients ages 20 and older who were diagnosed with invasive colorectal cancer from 1974 through 2013 in the nine areas that have been included in the Surveillance, Epidemiology, and End Results (SEER) Program the longest.

    The researchers found that 490,305 patients had been diagnosed with colorectal cancer in the nine areas reviewed between 1974 and 2013. According to the researchers, colorectal cancer diagnoses rates had declined among patients younger than age 50, and had increased in patients older than age 50, during the late 1970s and early 1980s. However, those trends shifted in the mid-1980s through 2013, when colorectal cancer diagnosis rates:

    • Declined in patients ages 55 and older;
    • Increased by 2.4 percent annually in patients ages 20 to 29; and
    • Increased by 1 percent annually in patients ages 30 to 39.

    Further, colorectal cancer diagnosis rates in the mid-1990s through 2013 increased by:

    • 1.3 percent annually in patients ages 40 to 49; and
    • 0.5 percent annually in patients ages 50 to 54.

    The researchers found that "incidence trends for rectal cancer are more prolonged for all age groups and the rise in young adults is steeper" when compared with colon cancer incidence trends. According to the researchers, rectal cancer diagnosis rates increased by:

    • 3.2 percent annually from 1974 to 2013 in patients ages 20 to 29 and from 1980 to 2013 in patients ages 30 to 39; and
    • 2.3 percent annually from the 1990s to 2013 in patients ages 40 to 54 years.

    In comparison, rectal cancer "rates generally declined throughout the entire 40-year study period in adults age 55 years and older," the researchers wrote. They added that "the probability of a rectal cancer diagnosis for someone in their early 50s is now the same as it is for someone in their late 50s, whereas two decades ago it was just half."

    While experts say it is unclear what is driving increased colorectal cancer rates among younger U.S. residents, the researchers noted that the increase has tracked closely with rising obesity rates. The researchers also cited other risk factors for colorectal cancer, such as excessive alcohol consumption, infectious diseases such as the human papillomavirus, and a sedentary lifestyle.

    Researchers estimate 135K US residents will be diagnosed with colorectal cancer this year

    Meanwhile, a separate study published by the ACS estimated that 135,430 U.S. residents will be diagnosed with colorectal cancer in 2017, and 50,260 individuals will die from the disease, "Science Now" reports. The researchers found people younger than 50 will account for about 10 percent of those new diagnoses and 7 percent of the deaths.

    The researchers' findings are based on data from CDC's National Center for Health Statistics from 1930 to 2014. The data were collected through the SEER program and CDC's National Program of Cancer Registries.

    The researchers predicted that of those 135,430 new diagnoses, 71,420 will occur among men, with:

    • 18 percent occurring among men older than 80;
    • 38 percent occurring among men ages 65 to 79;
    • 34 percent occurring among men ages 50 to 64; and
    • 11 percent occurring among men younger than 49.

    The researchers predicted that 64,010 of the new diagnoses will occur among women, with:

    • 27 percent occurring among women older than 80;
    • 35 percent occurring among women ages 65 to 79;
    • 28 percent occurring among women ages 50 to 64; and
    • 10 percent occurring among women younger than 49.

    According to the researchers, men overall are 30 percent more likely than women to be diagnosed with colorectal cancer in 2017 and 40 percent more likely to die from the disease. The researchers wrote that "reasons for higher rates in men are not completely understood but to some extent likely reflect differences in exposures to risk factors and sex hormones, as well as complex interactions between these influences."

    The researchers also found racial and ethnic disparities in colorectal cancer rates. According to the study, colorectal incidence rates from 2009 through 2013 among non-Hispanic blacks were about 20 percent higher than they were among non-Hispanic whites and about 50 percent higher than they were among Asian Americans/Pacific Islanders. In addition, colorectal cancer death rates from 2010 through 2014 among non-Hispanic blacks were 40 percent higher than they were among non-Hispanic whites and about twice as high as they were among Asian Americans/Pacific Islanders. The researchers wrote that the disparity likely stemmed from "disproportionately low socioeconomic status, which is associated with a higher risk of [colorectal cancer] incidence and death."

    The researchers stated that reducing disparities in colorectal cancer incidence and death rates "can be achieved by ensuring access to high-quality health care for all patients and incentivizing healthier lifestyles to prevent cancer occurrence." They added that many cases of colorectal cancer and deaths from the disease could be prevented by increased screening (Healy, "Science Now," Los Angeles Times, 3/1; Siegel et al., Journal of the National Cancer Institute, 2/28; Rabin, "Well," New York Times, 2/28; McGinley, "To Your Health," Washington Post, 2/28; Painter, USA Today, 2/28).

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