New US data show that the rate of colorectal cancer (CRC) is on the rise among people aged 50-54 years, mirroring the well-documented increases in early-onset CRC in persons younger than 50 years old.
“It’s possible that the causes that cause CRC at 50-54 years old are the same ones that contribute to early-onset CRC that has been increasing in parallel,” Caitlin Murphy, MPH, University of Texas Health Science Center at Houston said in Medscape Medical News.
“Many studies in the last year have demonstrated that CRC risk factors in younger adults include overweight and the sedentary lifestyles. Murphy said that there is a growing amount of evidence suggesting that exposures to chemicals in the early years of childhood, infancy, or even the womb play a crucial role in the development of CRC.
The study was published online October 28 in Gastroenterology.
Murphy and colleagues examined trends of age-specific CRC incidence rates in individuals aged between 45-49 and 50-54 using the National Cancer Institute Surveillance Epidemiology and End Results (SEER).
Between 1992 and 2018 there were 101,609 cases of CRC in adults aged 45-59.
Further analysis revealed that CRC incidence rates rose from 23.4 percent to 34.0 per 100 people under 45-49 years old, and from 46.4 percent to 63.8 per 100 under the age of 50-54.
Conversely, incidence rates decreased for those aged 55-59 years between 81.7 to 63.7 per 100,000 persons.
Researchers write that “Due to this opposing trend — which is a decrease in incidence rates for those aged 55-59 years, and increasing rates for those 50-54 years old the rates of incidence for both age groups were almost identical in 2016-18.”
Researchers also noted the existence of a “clear pattern” of an increase in CRC incidence for adults 50 years old and older. This supports the hypothesis that those at higher risk of developing the disease get older at a younger age, which would support the hypothesis that CRC incidence rates increase with the age of the patient.
Murphy stated that these data send a clear signal to Medscape Medical News.
“Don’t delay colorectal cancer screening. Encourage prompt screening by speaking to patients about screening prior to the age when it is recommended. Murphy declared that the US Preventive Services Task Force recommends starting the average risk screening at the age of 45.
Intriguing, but Not Surprising
Rebecca Siegel MPH, scientific director of Surveillance Research at American Cancer Society in Atlanta, Georgia, said that the findings were “not unexpected” and mirrored the findings of a study in 2017 that revealed an increase in CRC among those aged 50-54. Medscape Medical News reported .
Siegel stated that it is “concerning” that people in this age range “have been advised to screen for CRC for decades. We hope that, since the age for screening has been reduced from 50 to 45 years, this uptick will eventually flatten.”
David Johnson, MD is an instructor of medicine at Eastern Virginia Medical School in Norfolk, Virginia. He was not a participant in the study. Johnson said that the increasing incidence is “concerning” for the younger population. This is similar to the current trend for the 45-to-49-year-old population.
“Recent data have linked dietary influences in the early development of precancerous colon polyps as well as colon cancer. Johnson said that the cause of these striking epidemiologic shifts is likely to be related to the increased consumption of processed foods and drinks that are sugary, which most of which contain high fructose corn syrup.
“These issues will likely to be amplified by the COVID-related adverse consequences on individuals [in the context of] timely and appropriate colorectal cancer screening,” Johnson added.
The National Cancer Institute at National Institutes of Health has backed the study. Murphy has spoken with Freenome. Siegel and Johnson have reported no relevant financial connections.
Gastroenterology. Online publication on October 28, 2021. Abstract
Content Source: https://www.medscape.com/viewarticle/962769?src=rss