Colorectal cancer incidence rate rising in young patients — 6 insights

An article, published in AGA Perspectives, explored the increasing incidence rate of colorectal cancer in people under 50 years old.

Uri Ladabaum, MD, of Stanford (Calif.) University, explained the recent phenomenon.

Here's what you should know:

1. Colon and rectal cancer incidence rates have increased in young populations since the mid-1980s.

  • In 20-to 29-year-old patients, rates increased 2.4 percent and 3.2 percent, respectively
  • In 30-to 39-year-old patients, rates increased 1 percent and 3.2 percent
  • In 40- to 49-year-old patients, rates increased 1.3 percent and 2.3 percent

2. Dr. Ladabaum contrasted the increases in younger populations to the decrease in the 50 years-plus population. While rates are still minute in young populations, incidence rate ratios for the 50-to 84-year-old patient population dropped from 30 to 200 cases per every 100,000 people to 20 to 50 cases per every 100,000 people since the mid-1980s.

3. There's no conclusive evidence why CRC is increasing in a young population. Dr. Ladabaum speculates there might be unique molecular phenotypes causing early onset CRC, but that is still unconfirmed.

4. While the increased incidence rate is "concerning," Dr. Ladabaum said population-based screening would be neither practical nor cost effective. The U.S. Multi-Society Taskforce found insufficient evidence to recommend lowering the screening age.

5. Dr. Ladabaum said, "In most young patients with CRC, it seems that 'CRC just happens,' and we lack ways to identify these patients for early screening."

6. Until research around the cause of the phenomenon is complete, Dr. Ladabaum recommends physicians identify cancer genetic syndromes in a patient's family to manage the syndrome in young family members. He also recommends patients with a family history undergo early screening.

To read his whole piece, click here.

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