Increasing colorectal cancer incidence in individuals aged < 50 years—a population-based study
- 75 Downloads
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.
KeywordsColorectal cancer Incidence Sweden Screening
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interests.
- 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. https://doi.org/10.1111/jgh.12792 CrossRefGoogle Scholar
- 10.SCRCR (2016) Tjock- och ändtarmscancer - Nationellt vårdprogram. Swedish Colorectal Cancer RegistryGoogle Scholar
- 15.Folkhalsomyndigheten (2018) Övervikt och fetma. https://www.folkhalsomyndigheten.se/folkhalsorapportering-statistik/folkhalsans-utveckling/levnadsvanor/overvikt-och-fetma/
- 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. https://doi.org/10.1158/1055-9965.Epi-06-0595 CrossRefGoogle Scholar
- 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. https://doi.org/10.1097/MD.0b013e3181881354 CrossRefGoogle Scholar
- 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. https://doi.org/10.1097/dcr.0000000000001188