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Incidence of colon resections is increasing in the younger populations: should an early initiation of colon cancer screening be implemented?

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Abstract

Introduction

The American Cancer Society recently lowered the recommended age for screening of colorectal cancer (CRC) to age 45 due to recent data showing increased incidence of CRC in younger populations. The purpose of this study was to evaluate if younger patients have increased likelihood of resection for CRC through the use of a statewide longitudinal database.

Methods

The New York SPARCS administrative database was used to identify all patients with diagnosis of colon cancer undergoing colorectal resections from 2000 to 2016. Patients were divided into seven age groups. Patients’ characteristics, demographics, co-morbidities, and complications were evaluated. Chi-square test was used to compare patients’ characteristics, comorbidities and complications among age groups. The linear trend of colon resection in different age groups over years was examined using log-linear Poisson regression models with year as an explanatory variable, as well as using multivariable logistic regression models after adjusting for patients’ gender, race, payment, region, any comorbidity and any complication.

Results

There were 73,697 colon resection surgeries extracted from 2000 to 2016. Younger age was significantly associated with increased colorectal cancer resection over time. Patients age 21–70 had a significantly increasing trend over the years (age group 21–30: RR 1.06, p-value < 0.0001; age group 31–40: RR 1.04, p < 0.0001; age group 41–50: RR 1.04, p < 0.0001; age group 51–60: RR 1.02. p < 0.0001); age group 61–70: RR 1.01, p = 0.0012). Patient age > 70 was significantly associated with decreasing trend of colorectal cancer resection over the years (age group 71–80: RR 0.98, p < 0.0001 and age group > 80: RR 0.99, p-value < 0.0001). Such trends also existed after further adjustment for patients’ characteristics, any comorbidity and any complication.

Conclusion

Over the years, younger patients have an increased trend of undergoing colorectal resections for cancer, with up to a 6% yearly increase over the studied period. New screening initiation guidelines should be considered and awareness among clinicians and the general public should be increased.

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Authors and Affiliations

  1. Division of General and Bariatric Surgery, Department of Surgery, East Carolina University Brody School of Medicine, 600 Moye Boulevard, Greenville, NC, 27834, USA

    Maria S. Altieri

  2. Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA

    Hannah Thompson, Aurora Pryor, Mark Talamini & Jill Genua

  3. Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA

    Jie Yang

  4. Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA

    Chencan Zhu

Authors
  1. Maria S. Altieri
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  2. Hannah Thompson
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  4. Jie Yang
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  6. Mark Talamini
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  7. Jill Genua
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Corresponding author

Correspondence to Maria S. Altieri.

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Disclosures

Dr. Pryor is a speaker for Ethicon, Gore, Merck and Stryker, and a consultant for Medtronic. She has research support from Baronova and Obalon. Drs. Altieri, Talamini, Yang, Thompson, Genua and Ms. Zhu have no conflicts of interest or financial ties to disclose.

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Altieri, M.S., Thompson, H., Pryor, A. et al. Incidence of colon resections is increasing in the younger populations: should an early initiation of colon cancer screening be implemented?. Surg Endosc 35, 3636–3641 (2021). https://doi.org/10.1007/s00464-020-07842-8

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  • DOI: https://doi.org/10.1007/s00464-020-07842-8

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