Updated Assessment of Colorectal Cancer Incidence in the U.S. by Age, Sex, and Race/Ethnicity
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Whether recent updates to colon cancer screening guidelines benefit men and women or all race/ethnic groups equally is not clear.
The aim of this study is to evaluate age-, sex-, and race/ethnicity-specific trends in CRC incidence and disease burden among adults.
Using 2000–2014 surveillance, epidemiology, and end results database, annual CRC incidence (per 100,000 persons/year) among U.S. adults was categorized by age (using 10-year age intervals) and stratified by sex and race/ethnicity. Comparison of incidence between groups utilized the z-statistic with p < 0.05 indicating statistical significance.
Overall, CRC incidence was the highest among patients aged ≥ 80 years (330.8 per 100,000 persons/year), which was significantly higher in men versus women (377.2 vs. 304.3 per 100,000 persons/year, p < 0.001). CRC incidence in younger individuals was 22.8 per 100,000 persons/year (age 40–49) and 6.8 per 100,000 persons/year (age 30–39). CRC incidence was significantly higher in African Americans compared to non-Hispanic whites. From 2000 to 2014, CRC incidence declined in all age groups over age 60, remained stable in age 50–59, and demonstrated proportional increases in among age 20–49 years. While CRC incidence in all race/ethnic groups aged ≥ 60 years declined, Hispanics aged 50–59 increased 21.9%, but remained stable in other race/ethnic groups. Race/ethnicity-specific disparities in CRC incidence in patients aged 20–49 were also observed.
While CRC incidence has declined among U.S. adults aged ≥ 60, increasing incidence among patients aged < 50 is concerning. Identifying risk factors among “average-risk” patients is needed to better implement targeted screening of individuals not currently meeting CRC screening criteria.
KeywordsColon cancer SEER Epidemiology Race/ethnicity
Surveillance, epidemiology, and end results
Annual percentage change
Biannual percentage change
RW guarantor of the article. RW and AO: involved in study concept and design. RW involved in acquisition of data. AO, AR, BL, TB, and RW involved in analysis and interpretation of data. AO and RW involved in statistical analysis. AO and RW involved in drafting of the manuscript. AO, AR, BL, TB, and RW involved in critical revision of the manuscript for important intellectual content. RW involved in study supervision. RW had full access to all the data in the study and took responsibility for the integrity of the data and accuracy of the data analysis.
No funding was provided for this study. Robert Wong is supported by an AASLD Foundation Clinical and Translational Research Award in Liver Diseases.
Compliance with Ethical Standards
Conflict of interest
Robert J. Wong: Advisory board, consultant, speaker’s bureau, and research Grants—Gilead Sciences; Speakers bureau: Salix, Bayer; Research Grant: Abbvie. Ajay Ohri, Ann Robinson, Benny Liu, Taft Bhuket: None.
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