State variation in early-onset colorectal cancer in the United States, 1995-2015
Menée aux Etats-Unis, cette étude analyse les disparités géographiques dans l'évolution de l'incidence du cancer colorectal chez les personnes âgées de 20 à 49 ans et identifie les facteurs de risque associés, sur la période 1995-2015
The extent to which the increase in early-onset colorectal cancer (CRC) in the US varies geographically is unknown. We analyzed changes in CRC incidence and risk factors among people 20-49 years by state using high-quality population-based cancer registry data provided by the North American Association of Central Cancer Registries and national survey data, respectively. Early-onset CRC incidence was mostly stable among blacks and Hispanics, but increased in 40/47 states among non-Hispanic-whites, most prominently in western states. For example, rates increased in Washington from 6.7 (per 100,000) during 1995-1996 to 11.5 during 2014-2015 (rate ratio = 1.73; 95% confidence interval = 1.48-2.01) and in Colorado from 6.0 to 9.5 (rate ratio = 1.57; 95% confidence interval = 1.30-1.91). Nevertheless, current CRC incidence was highest in Southern states. From 1995-2005, increases occurred in obesity prevalence in all states and heavy alcohol consumption in one-third of states, but neither were correlated with CRC incidence trends. Early-onset CRC is increasing most rapidly among whites in Western states. Etiologic studies are needed to explore early-life colorectal carcinogenesis.