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Digestive Diseases and Sciences

, Volume 64, Issue 12, pp 3602–3609 | Cite as

Epidemiology of Colorectal Cancer in Average Risk Adults 20–39 Years of Age: A Population-Based National Study

  • Michael Glover
  • Emad Mansoor
  • Muhammed Panhwar
  • Sravanthi Parasa
  • Gregory S. CooperEmail author
Original Article

Abstract

Background/Aims

While overall rates of colorectal cancer (CRC) have declined in individuals aged above 50 years of age, this decline has not been seen in younger individuals who do not benefit from current screening guidelines. We sought to describe the prevalence of CRC in adults 20–39 years of age without family history of CRC or inflammatory bowel disease as early-onset CRC (EoCRC), evaluate associated signs and symptoms and medical comorbidities in EoCRC, and compare them with individuals aged 20–39 years without CRC (NoCRC). Our secondary aim was to compare EoCRC with individuals aged 40 years and above with CRC (LoCRC).

Methods

Utilizing a commercial database (Explorys Inc, Cleveland, OH), we identified a cohort of patients aged 20–39 years with first ever diagnosis of CRC between 2013 and 2018 based on the Systematized Nomenclature of Medicine-Clinical Terms. We calculated the overall prevalence rate of EoCRC, described age, race, and gender-based prevalence rates of EoCRC, and identified associated symptoms and medical comorbidities associated with EoCRC.

Results

The overall rate of EoCRC was 18.9/100,000. Compared to NoCRC, EoCRC patients were more likely to be Caucasian and female, with predominant symptoms of hematochezia, anemia, and decreased appetite. EoCRC group had higher prevalence rates of medical comorbidities such as diabetes, smoking, and obesity. Compared to LoCRC, EoCRC group presented more frequently with left-sided CRC and rectal cancers.

Conclusion

This is one of the largest studies to date to describe the epidemiology of EoCRC in USA. We found EoCRC to occur predominantly in the Caucasian and female population. EoCRC presented more frequently with left-sided and rectal CRC. We also identified signs/symptoms as well as comorbidities associated with EoCRC. Patients with these features may benefit from earlier screening.

Keywords

Colon cancer Early-onset colon cancer Cancer epidemiology Cancer screening 

Notes

Author contributions

MG, EM, SP and GSC contributed to study conception and design. MG contributed to acquisition of data. MG, EM, SP and GSC contributed to analysis and interpretation of data. MG, EM, SP and GSC contributed to drafting of manuscript. EM, SP and GSC contributed to critical revision. MG, MP contributed to statistical analysis. GSC obtained funding. SP and GSC contributed to study supervision.

Compliance with Ethical Standards

Conflicts of interest

Glover, Mansoor, Panhwar, Parasa, and Cooper deny any relevant personal or financial conflicts of interest related to the material in this manuscript.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Michael Glover
    • 1
  • Emad Mansoor
    • 2
  • Muhammed Panhwar
    • 1
  • Sravanthi Parasa
    • 2
    • 3
  • Gregory S. Cooper
    • 2
    Email author
  1. 1.Department of Internal Medicine, University Hospitals Cleveland Medical CenterCase Western Reserve UniversityClevelandUSA
  2. 2.Department of Internal Medicine and Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical CenterCase Western Reserve UniversityClevelandUSA
  3. 3.Swedish Medical CenterSeattleUSA

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