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Colorectal Cancer in Young African Americans: Is It Time to Revisit Guidelines and Prevention?

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Abstract

Background & Aims

Previous studies have suggested an increase in the incidence of colorectal cancer (CRC) in young adults (younger than 50 years). Among older people, African Americans have disproportionally higher CRC incidence and mortality. We assessed whether this CRC disparity also applies to CRC diagnosed among young people.

Methods

Using the Surveillance, Epidemiology, and End Results cancer registries, a population-based cancer registry covering 25.6 % of the United States’ African American population, we identified patients diagnosed with CRC between the years of 2000–2012. The age-adjusted rates for non-Hispanic whites (NHW), African Americans, and Asian–Pacific Islanders (API) were calculated for the age categories 20–24, 25–29, 30–34, 35–39, and 40–44.

Results

CRC age-adjusted incidence is increasing among all three racial groups and was higher for African Americans compared to NHW and API across all years 2000–2012 (P < 0.001). Stage IV CRC was higher in African Americans compared with NHW, while there was higher stage III CRC in API compared with NHWs.

Conclusion

CRC incidence is increasing among the young in all racial groups under study. This increase in frequency of CRC is true among young African American adults who display highly advanced tumors in comparison with other races. While the present attention to screening seems to have decreased CRC prevalence in individuals older than 50, special attention needs to be addressed to young African American adults as well, to counter the observed trend, as they have the highest incidence of CRC among young population groups by race/ethnicity.

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References

  1. American Cancer Society. Colorectal cancer facts & figures 2014–2016, 2014. http://www.cancer.org/acs/groups/content/documents/document/acspc-042280.pdf.

  2. Bailey CE, Hu CY, You YN, et al. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010. JAMA Surg. 2015;150:17–22.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Siegel RL, Jemal A, Ward EM. Increase in incidence of colorectal cancer among young men and women in the United States. Cancer Epidemiol Biomark Prev. 2009;18:1695–1698.

    Article  Google Scholar 

  4. Austin H, Henley SJ, King J, Richardson LC, Eheman C. Changes in colorectal cancer incidence rates in young and older adults in the United States: what does it tell us about screening. Cancer Causes Control. 2014;25:191–201.

    Article  PubMed  Google Scholar 

  5. O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY. Rates of colon and rectal cancers are increasing in young adults. Am Surg. 2003;69:866–872.

    PubMed  Google Scholar 

  6. You YN, Xing Y, Feig BW, Chang GJ, Cormier JN. Young-onset colorectal cancer: is it time to pay attention? Arch Internal Med. 2012;172:287–289.

    Article  Google Scholar 

  7. Fairley TL, Cardinez CJ, Martin J, et al. Colorectal cancer in US adults younger than 50 years of age, 1998–2001. Cancer. 2006;107:1153–1161.

    Article  PubMed  Google Scholar 

  8. Amri R, Bordeianou LG, Berger DL. The conundrum of the young colon cancer patient. Surgery. 2015;158:1696–1703.

    Article  PubMed  Google Scholar 

  9. Singh KE, Taylor TH, Pan CJG, Stamos MJ, Zell JA. Colorectal cancer incidence among young adults in California. J Adolesc Young Adult Oncol. 2014;3:176–184.

    Article  PubMed  PubMed Central  Google Scholar 

  10. American Cancer Society. Cancer facts & figures for African Americans 2013–2014, 2013. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036921.pdf. Accessed 12/10/15, 2015.

  11. Siegel R, Desantis C, Jemal A. Colorectal cancer statistics, 2014. CA Cancer J Clin. 2014;64:104–117.

    Article  PubMed  Google Scholar 

  12. Rahman R, Schmaltz C, Jackson CS, Simoes EJ, Jackson-Thompson J, Ibdah JA. Increased risk for colorectal cancer under age 50 in racial and ethnic minorities living in the United States. Cancer Med. 2015;4:1863–1870.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Carethers JM. Screening for colorectal cancer in African Americans: determinants and rationale for an earlier age to commence screening. Dig Dis Sci. 2015;60:711–721.

    Article  PubMed  Google Scholar 

  14. SEER*Stat Database: Incidence-SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisana Cases, Nov 2014. www.seer.cancer.gov.

  15. Greene FL, Page DL, Fleming ID, et al., eds. AJCC Cancer Staging Manual. Berlin: Springer; 2002.

    Google Scholar 

  16. Gress DM. Explaining Blanks and X, Ambiguous Terminology and Support for AJCC Staging. Chicago, IL: American Joint Committee on Cancer; 2014.

    Google Scholar 

  17. Ashktorab H, Paydar M, Namin HH, et al. Prevalence of colorectal neoplasia among young African Americans and Hispanic Americans. Dig Dis Sci. 2014;59:446–450.

    Article  PubMed  Google Scholar 

  18. Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM. American College of Gastroenterology guidelines for colorectal cancer screening 2009. Am J Gastroenterol. 2009;104:739–750.

    Article  PubMed  Google Scholar 

  19. Ahnen DJ, Wade SW, Jones WF, et al. The increasing incidence of young-onset colorectal cancer: a call to action. Mayo Clin Proc. 2014;89:216–224.

    Article  PubMed  Google Scholar 

  20. Gupta S, Shah J, Balasubramanian BA. Strategies for reducing colorectal cancer among blacks. Arch Internal Med. 2012;172:182–184.

    Article  Google Scholar 

  21. Wallace K, Brandt HM, Bearden JD, et al. Race and prevalence of large bowel polyps among the low-income and uninsured in South Carolina. Dig Dis Sci. 2016;61:265–272.

    Article  PubMed  Google Scholar 

  22. Paquette IM, Ying J, Shah SA, Abbott DE, Ho SM. African Americans should be screened at an earlier age for colorectal cancer. Gastrointest Endosc. 2015;82:878–883.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Steele CB, Rim SH, Joseph DA, King JB, Seeff LC. Colorectal cancer incidence and screening—United States, 2008 and 2010. MMWR Surveill Summ. 2013;62:53–60.

    Google Scholar 

  24. Laiyemo AO, Doubeni C, Pinsky PF, et al. Race and colorectal cancer disparities: health-care utilization vs different cancer susceptibilities. J Natl Cancer Inst. 2010;102:538–546.

    Article  PubMed  PubMed Central  Google Scholar 

  25. DeSantis C, Naishadham D, Jemal A. Cancer statistics for African Americans, 2013. CA Cancer J Clin. 2013;63:151–166.

    Article  PubMed  Google Scholar 

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Correspondence to Hassan Ashktorab.

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Ashktorab, H., Vilmenay, K., Brim, H. et al. Colorectal Cancer in Young African Americans: Is It Time to Revisit Guidelines and Prevention?. Dig Dis Sci 61, 3026–3030 (2016). https://doi.org/10.1007/s10620-016-4207-1

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  • DOI: https://doi.org/10.1007/s10620-016-4207-1

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