Cancer Causes & Control

, Volume 25, Issue 2, pp 191–201

Changes in colorectal cancer incidence rates in young and older adults in the United States: what does it tell us about screening

  • Harland Austin
  • S. Jane Henley
  • Jessica King
  • Lisa C. Richardson
  • Christie Eheman
Original paper

Abstract

Purpose

Colorectal cancer (CRC) incidence rates have increased among young adults and have decreased among older adults. We re-evaluated these trends using more recent data covering about 96 % of the United States population.

Methods

Colorectal cancer incidence rates were abstracted from the National Program of Cancer Registries and the Surveillance Epidemiology and End Results analytic files for diagnosis years 1998–2009. We report rates for young adults (age <50 years) and for older adults (age 50 years or older) by four race/ethnicity groupings. We examined CRC incidence rates by stage at diagnosis, tumor subsite, and state. We calculated the correlation between state-specific CRC incidence and prevalence of colonoscopy reported in the Behavioral Risk Factor Surveillance System.

Results

Rectal cancer incidence rates increased from 1998 through 2009 among young non-Hispanic white adults and young blacks. Among older adults, CRC incidence rates decreased among all four race/ethnicity groupings and in all states. The decline was apparent for all stages and for all subsites. States with greater decreases in CRC incidence rates had higher colonoscopy screening rates.

Conclusion

Rectal cancer is increasing among younger adults, for reasons largely unknown. Among older adults, CRC incidence continues to decrease, probably because of increasing uptake of colonoscopy screening. Decreases in CRC incidence are correlated with increased use of colonoscopy, indicating that CRC may be largely preventable through colonoscopy screening. Efforts to increase screening rates in underserved populations would help reduce health disparities associated with this type of cancer.

Keywords

Colorectal Cancer Colonoscopy Incidence Trends 

References

  1. 1.
    U.S. Preventive Services Task Force (2008) Screening for colorectal cancer. Recommendation statement. Oct 2008 www.uspreventiveservicestaskforce.org
  2. 2.
    Siegel RL, Ward EM, Jemal A (2012) Trends in colorectal cancer incidence rates in the United States by tumor location and stage, 1992-2008. Cancer Epidemiol Biomarkers Prev 21:411–416PubMedCrossRefGoogle Scholar
  3. 3.
    Siegel RL, Jemal A, Ward EM (2009) Increase in incidence of colorectal cancer among young men and women in the United States. Cancer Epidemiol Biomarkers Prev 18:1695–1698PubMedCrossRefGoogle Scholar
  4. 4.
    Surveillance Research Program, National Cancer Institute SEER*Stat software version 7.0.5. Available at: seer.cancer.gov/seerstatGoogle Scholar
  5. 5.
    National Program of Cancer Registries, United States Cancer Statistic, Centers for Disease Control and Prevention (2012) Available at http://www.cdc.gov/cancer/npcr/uscs/technical_notes/criteria.htm/ Accessed 14 Feb 2012
  6. 6.
    SEER Site Recode, ICD-O-3 (1/27/2003) Definition (2012) Available at: http://seer.cancer.gov/siterecode/icdo3_d01272003/ Accessed 19 Sept 2012
  7. 7.
    Fritz A, Ries L (eds) (2012) SEER extent of disease-1988. Codes and coding instructions, 3rd edn. National Cancer Institute 1998 available at: http://seer.cancer.gov/manuals/EOD10Dig.pub.pdf. Accessed 19 Sept 2012
  8. 8.
    Young JL Jr, Roffers SD, Ries LAG, Fritz AG, Hurlbut AA (eds) (2012) SEER summary staging manual-2000: codes and coding instructions, National Cancer Institute, NIH Pub. No. 01-4969, Bethesda, MD, 2001. Available at: http://seer.cancer.gov/tools/ssm/. Accessed 4 Jan 2012
  9. 9.
    Collaborative Staging Task Force of the American Joint Committee on Cancer. Collaborative Staging Manual and Coding Instructions, version 01.04.00: Jointly published by American Joint Committee on Cancer (Chicago, IL) and U.S. Department of Health and Human Services (Bethesda, MD), 2004. NIH Publication Number 04-5496. Incorporates updates through 8 Sept 2006Google Scholar
  10. 10.
    Collaborative Staging Task Force. Collaborative Stage Data Collection System, Collaborative Staging (2012) Available at: http://www.cancerstaging.org/cstage/cstageintro.html. Accessed 3 Jan 2012
  11. 11.
    Austin H, Duong LM, King J, Richardson LC, Eheman C (2012) A method to adjust for stage coding changes in the national program of cancer registries illustrated for colorectal cancer. J Regist Manag 39(2):62–68Google Scholar
  12. 12.
    Spiegelhalter DJ (2005) Funnel plots for comparing institutional performance. Stat Med 24:1185–1202PubMedCrossRefGoogle Scholar
  13. 13.
    Centers for Disease Control and Prevention (CDC). Behavioral risk factor surveillance system survey data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 1997, 1999, 2002, 2004, 2006, and 2008. Available at http://www.cdc.gov/brfss/index.htm Accessed 16 April 2013
  14. 14.
    StataCorp. (2011) Stata: release 12. Stata Corp LP, College StationGoogle Scholar
  15. 15.
    Wingo PA, Jamison PM, Hiatt RA, Weir HK, Gargiulla PM, Hutton M, Lee NC, Hall HI (2003) Building the infrasctructure for nationwide cancer surveillance and control: a comparison between The National Program of Cancer Registries (NPCR) and The Surveillance, Epidemiology, and End Results (SEER) Program (United States). Cancer Causes Control 14:175–193PubMedCrossRefGoogle Scholar
  16. 16.
    Larsson SC, Wolk A (2007) Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr 86:556–565PubMedGoogle Scholar
  17. 17.
    Centers for Disease Control and Prevention (CDC). Behavioral risk factor surveillance system survey data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Available at http://www.cdc.gov/brfss/index.htm Accessed 16 April 2013
  18. 18.
    Larsson SC, Orsini N, Wolk A (2005) Diabetes mellitus and risk of colorectal cancer: a meta-analysis. J Natl Cancer Inst 97:1679–1687PubMedCrossRefGoogle Scholar
  19. 19.
    Naishadham D, Lansdorp-Vogelaar I, Siegel R, Cokkinides V, Jemal A (2011) State disparities in colorectal cancer mortality patterns in the United States. Cancer Epidemiol Biomarkers Prev 20(7):1296–1302PubMedCrossRefGoogle Scholar
  20. 20.
    Shapiro JA, Klabunde CN, Thompson TD, Nadel MR, Seeff LC, White A (2012) Patterns of colorectal cancer test use, including CT colonography, in the 2010 National Health Interview Survey. Cancer Epidemiol Biomarkers Prev 21(6):895–904PubMedCrossRefGoogle Scholar
  21. 21.
    Centers for Disease Control and Prevention (2011) Vital signs: colorectal cancer screening, incidence, and mortality-United States, 2002–2010. MMWR Morb Mortal Wkly Rep 60(26):884–889Google Scholar
  22. 22.
    National Center for Health Statistics (2013) Health, United States, 2012: with special feature on emergency care. Hyattsville, MDGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht (outside the USA) 2013

Authors and Affiliations

  • Harland Austin
    • 1
    • 3
  • S. Jane Henley
    • 2
  • Jessica King
    • 2
  • Lisa C. Richardson
    • 2
  • Christie Eheman
    • 2
  1. 1.Rollins School of Public HealthEmory UniversityAtlantaUSA
  2. 2.Cancer Surveillance Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaUSA
  3. 3.AtlantaUSA

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