Increasing colorectal cancer incidence among young adults in England diagnosed during 2001-2014

Abstract

Background: Colorectal cancer predominantly affects adults above 50 years of age, but emerging evidence suggests that, in high-income countries, incidence has been increasing among young adults. Methods: We examined incidence trends for primary, invasive malignancy of the large bowel among all adults (20-99 years) diagnosed during 2001-2014, using joinpoint regression to analyse data from the national cancer registry for England (pop. 55 million). We present the annual percentage change (APC%) in incidence rates by sex, age, deprivation (five categories) and anatomic sub-site. Results: Annual incidence rates among the youngest adults (20-29 years) increased 3-fold between 2001 and 2014 (APC 7.2% for men, 9.4% for women), with a 2-fold increase among slightly older adults (30-39 years). Among adults over 50 years of age, incidence rates have barely changed. Incidence increased in all five deprivation groups, but more quickly among the two most deprived groups. Among the two age groups combined (20-39 years), the APC for the right colon was 6.9% between 2001 and 2010, with a dramatic jump to 19.5% per year between 2010 and 2014. Conclusions: The cause of this striking increase is unknown, but our study suggests that GPs and hospital clinicians should be alert to the increasing risk of colorectal cancer in young adults. National strategies to raise awareness of symptoms or ways to seek medical care may also be considered for high-risk groups, such as those who are obese, with high alcohol consumption or a sedentary lifestyle.