International Journal of Colorectal Disease

, Volume 34, Issue 7, pp 1221–1226 | Cite as

Increasing colorectal cancer incidence in individuals aged < 50 years—a population-based study

  • Ida GutlicEmail author
  • Tommy Schyman
  • Marie-Louise Lydrup
  • Pamela Buchwald
Original Article



Data on the incidence of colorectal cancer (CRC) is conflicting, and it is unknown if the incidence is constant, declining, or increasing. Proximal colon cancer is considered to be more common among older individuals, but recent data have shown that rectal cancer and distal colon cancer have been increasing in the younger population. The aim of this study was to determine the trends regarding CRC incidence and tumour location in Sweden.


CRC statistics from the National Board of Health and Welfare 1995–2015 were used. CRC incidence rates by age group (< 50 years, 50–79 years, ≥ 80 years), sex, and tumour localisation (proximal colon, distal colon, or rectum) were calculated and analysed using Poisson regression.


The age-standardised incidence of CRC increased in Sweden during the study period. This increase was significant (P < 0.0001) for colon cancer during the study period for all age groups regardless of tumour localisation. The greatest increase (27–52% per decade) in the colon cancer incidence rate was seen among men and women < 50 years of age. The incidence rate for rectal cancer increased for men < 50 years (P < 0.0001), decreased for both men and women aged ≥ 80 years (P < 0.005), and did not change for the remaining groups.


The CRC incidence in Sweden, in particular colon cancer, is increasing regardless of tumour localisation for individuals < 50 years of age. This paper supports the implementation of population-based colorectal cancer screening. A diagnostic workup should be performed in symptomatic individuals < 50 years of age.


Colorectal cancer Incidence Sweden Screening 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interests.


  1. 1.
    Inra JA, Syngal S (2015) Colorectal cancer in young adults. Dig Dis Sci 60(3):722–733. CrossRefGoogle Scholar
  2. 2.
    Gandhi J, Davidson C, Hall C, Pearson J, Eglinton T, Wakeman C, Frizelle F (2017) Population-based study demonstrating an increase in colorectal cancer in young patients. Br J Surg 104(8):1063–1068. CrossRefGoogle Scholar
  3. 3.
    O'Connell JB, Maggard MA, Livingston EH, Yo CK (2004) Colorectal cancer in the young. Am J Surg 187(3):343–348. CrossRefGoogle Scholar
  4. 4.
    Patel P, De P (2016) Trends in colorectal cancer incidence and related lifestyle risk factors in 15-49-year-olds in Canada, 1969-2010. Cancer Epidemiol 42:90–100. CrossRefGoogle Scholar
  5. 5.
    Siegel RL, Jemal A, Ward EM (2009) Increase in incidence of colorectal cancer among young men and women in the United States. Cancer Epidemiol Biomark Prev 18(6):1695–1698. CrossRefGoogle Scholar
  6. 6.
    Young JP, Win AK, Rosty C, Flight I, Roder D, Young GP, Frank O, Suthers GK, Hewett PJ, Ruszkiewicz A, Hauben E, Adelstein BA, Parry S, Townsend A, Hardingham JE, Price TJ (2015) Rising incidence of early-onset colorectal cancer in Australia over two decades: report and review. J Gastroenterol Hepatol 30(1):6–13. CrossRefGoogle Scholar
  7. 7.
    Favoriti P, Carbone G, Greco M, Pirozzi F, Pirozzi RE, Corcione F (2016) Worldwide burden of colorectal cancer: a review. Updat Surg 68(1):7–11. CrossRefGoogle Scholar
  8. 8.
    Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012. CA Cancer J Clin 65(2):87–108. CrossRefGoogle Scholar
  9. 9.
    Welch HG, Robertson DJ (2016) Colorectal cancer on the decline--why screening can’t explain it all. N Engl J Med 374(17):1605–1607. CrossRefGoogle Scholar
  10. 10.
    SCRCR (2016) Tjock- och ändtarmscancer - Nationellt vårdprogram. Swedish Colorectal Cancer RegistryGoogle Scholar
  11. 11.
    Thorn M, Bergstrom R, Kressner U, Sparen P, Zack M, Ekbom A (1998) Trends in colorectal cancer incidence in Sweden 1959-93 by gender, localization, time period, and birth cohort. Cancer Causes Control 9(2):145–152CrossRefGoogle Scholar
  12. 12.
    Larsen IK, Bray F (2010) Trends in colorectal cancer incidence in Norway 1962-2006: an interpretation of the temporal patterns by anatomic subsite. Int J Cancer 126(3):721–732. CrossRefGoogle Scholar
  13. 13.
    Chauvenet M, Cottet V, Lepage C, Jooste V, Faivre J, Bouvier AM (2011) Trends in colorectal cancer incidence: a period and birth-cohort analysis in a well-defined French population. BMC Cancer 11:282. CrossRefGoogle Scholar
  14. 14.
    Aravani A, Downing A, Thomas JD, Lagergren J, Morris EJA, Hull MA (2018) Obesity surgery and risk of colorectal and other obesity-related cancers: an English population-based cohort study. Cancer Epidemiol 53:99–104. CrossRefGoogle Scholar
  15. 15.
  16. 16.
    Friedenreich C, Norat T, Steindorf K, Boutron-Ruault MC, Pischon T, Mazuir M, Clavel-Chapelon F, Linseisen J, Boeing H, Bergman M, Johnsen NF, Tjonneland A, Overvad K, Mendez M, Quiros JR, Martinez C, Dorronsoro M, Navarro C, Gurrea AB, Bingham S, Khaw KT, Allen N, Key T, Trichopoulou A, Trichopoulos D, Orfanou N, Krogh V, Palli D, Tumino R, Panico S, Vineis P, Bueno-de-Mesquita HB, Peeters PH, Monninkhof E, Berglund G, Manjer J, Ferrari P, Slimani N, Kaaks R, Riboli E (2006) Physical activity and risk of colon and rectal cancers: the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomark Prev 15(12):2398–2407. CrossRefGoogle Scholar
  17. 17.
    Larsson SC, Wolk A (2006) Meat consumption and risk of colorectal cancer: a meta-analysis of prospective studies. Int J Cancer 119(11):2657–2664. CrossRefGoogle Scholar
  18. 18.
    Taggarshe D, Rehil N, Sharma S, Flynn JC, Damadi A (2013) Colorectal cancer: are the “young” being overlooked? Am J Surg 205(3):312–316; discussion 316. CrossRefGoogle Scholar
  19. 19.
    Koo S, Neilson LJ, Von Wagner C, Rees CJ (2017) The NHS Bowel Cancer Screening Program: current perspectives on strategies for improvement. Risk Manag Healthc Policy 10:177–187. CrossRefGoogle Scholar
  20. 20.
    Dozois EJ, Boardman LA, Suwanthanma W, Limburg PJ, Cima RR, Bakken JL, Vierkant RA, Aakre JA, Larson DW (2008) Young-onset colorectal cancer in patients with no known genetic predisposition: can we increase early recognition and improve outcome? Medicine 87(5):259–263. CrossRefGoogle Scholar
  21. 21.
    Cheng L, Eng C, Nieman LZ, Kapadia AS, Du XL (2011) Trends in colorectal cancer incidence by anatomic site and disease stage in the United States from 1976 to 2005. Am J Clin Oncol 34(6):573–580. CrossRefGoogle Scholar
  22. 22.
    Chouhan H, Ferrandon S, DeVecchio J, Kalady MF, Church JM (2018) A changing spectrum of colorectal cancer biology with age: implications for the young patient. Dis Colon rectum.
  23. 23.
    Brändstedt J, Wangefjord S, Nodin B, Gaber A, Manjer J, Jirstrom K (2012) Gender, anthropometric factors and risk of colorectal cancer with particular reference to tumour location and TNM stage: a cohort study. Biol Sex Differ 3(1):23. CrossRefGoogle Scholar
  24. 24.
    Larsson SC, Wolk A (2007) Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr 86(3):556–565. CrossRefGoogle Scholar
  25. 25.
    Kune GA, Kune S, Watson LF (1990) Body weight and physical activity as predictors of colorectal cancer risk. Nutr Cancer 13(1–2):9–17. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Surgery, Colorectal UnitSkåne University HospitalMalmöSweden
  2. 2.Clinical Studies Sweden, Forum SouthSkåne University HospitalLundSweden

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