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Decrease in Incidence of Colorectal Cancer Among Individuals 50 Years or Older After Recommendations

Caitlin C Murphy1, Robert S Sandler2, Hanna K Sanoff3

  • 1Division of Epidemiology, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|September 10, 2016
PubMed
Summary

Colorectal cancer (CRC) incidence decreased in adults 50+ due to screening, but increased in those under 50. This highlights the need to evaluate screening for younger populations.

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Area of Science:

  • Oncology
  • Epidemiology
  • Public Health

Background:

  • Colorectal cancer (CRC) incidence is rising in US adults under 50, while decreasing in older populations.
  • Blacks exhibit higher CRC incidence rates compared to whites.
  • There is ongoing debate regarding the effectiveness of screening in reducing CRC incidence.

Purpose of the Study:

  • To examine age-related and race-related differences in CRC incidence over a 40-year period.
  • To evaluate the impact of screening on CRC incidence trends.
  • To inform potential adjustments to CRC screening guidelines.

Main Methods:

  • Utilized population-based Surveillance, Epidemiology, and End Results (SEER) cancer registry data from 1975-2013.
  • Analyzed age-standardized CRC incidence by 5-year age groups, time periods, tumor subsite, and stage at diagnosis.
  • Stratified analyses by race (white vs. black).

Main Results:

  • CRC incidence peaked between 1980-1989 and declined from 1990 onwards.
  • Decreases in CRC incidence were observed only in individuals aged 50 and older, with greater reductions in whites (40%) than blacks (26%).
  • CRC incidence in adults aged 20-49 increased from 1990-1994 to 2010-2013, with similar rates in whites and blacks.

Conclusions:

  • CRC incidence has decreased in individuals 50+ between 1980-1984 and 2010-2013, supporting the role of screening.
  • A modest increase in CRC incidence was observed in individuals aged 20-49 during the same period.
  • Further risk-benefit analysis is needed to determine screening recommendations for younger populations.