Trends in the incidence of young-onset colorectal cancer with a focus on years approaching screening age: A population-based longitudinal study
Menée au Canada à partir de données portant sur 3 614 patients atteints d'un cancer colorectal d'apparition précoce, cette étude analyse met en évidence l'augmentation de cette incidence aux alentours de l'âge de 50 ans (âge du dépistage)
Background : With recent evidence for the increasing risk of young-onset colorectal cancer (yCRC), our objective was to evaluate the incidence of yCRC in one-year age increments, particularly focusing around the screening age of 50 years. Methods : We conducted a longitudinal study using linked administrative health databases in British Columbia, Canada including a provincial cancer registry, inpatient/outpatient visits, and vital statistics from January 1, 1986 to December 31, 2016. We calculated incidence rates per 100,000 at every age from 20 to 60 years and estimated annual percent change in incidence (APCi) of yCRC using joinpoint regression analysis. Results : We identified 3,614 individuals with yCRC (49.9% women). The incidence of CRC steadily rose from 20 to 60 years, with a marked increase from 49 to 50 years (incidence rate ratio = 1.19; 95% confidence interval [CI] = 1.04 to 1.34). Furthermore, there was a trend of increased incidence of yCRC among women (APCi = 0.79%; 95% CI = 0.22% to 1.36%) and men (APCi = 2.17%; 95% CI = 1.59% to 2.76%). Analyses stratified by age yielded APCi’s of 2.49% (95% CI = 1.36% to 3.63%) and 0.12% (95% CI = -0.54% to 0.79%) for women aged 30-39 years and 40-49 years, respectively and 2.97% (95% CI = 1.65% to 4.31%) and 1.86% (95% CI = 1.19% to 2.53%) for men. Conclusion : Our findings indicate a steady increase over one-year age increments in the risk of yCRC during the years approaching and beyond screening age. These findings highlight the need to raise awareness as well as continue discussions regarding considerations of lowering the screening age.