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The Rising Incidence of Early-Onset Colorectal Cancer
Luana Fiengo Tanaka1, Sieglinde Hechenbichler Figueroa, Vera Popova
1Chair of Epidemiology, TUM Department of Sports and Health Sciences, Technical University of Munich(TUM), MunichCenter for International Health, University Hospital, Ludwig Maximilians University (LMU), MunichAssistant Professorship for Exercise, Nutrition, and Health, TUM Department of Sports and HealthSciences, Technical University of Munich (TUM)German Centre for Cancer Registry Data (ZfKD), Robert Koch Institute, BerlinBavarian State Office for Health and Food Safety, Bavarian Cancer Registry, Augsburg RegionalCenter.
Background:
The incidence of early-onset (diagnosis before age 50) colorectal cancer (EOCRC) is increasing in some high-income countries. In this study, we examined the trends in EO-CRC incidence in Germany.
Methods:
We obtained data on CRC (ICD-10 C18-C20) incidence from the Centre for Cancer Registry Data (excluding cases reported via death certificate only) and on mortality from the official cause of death statistics for 1999-2018 from registries with sufficient incidence coverage. To assess time trends for persons aged 20-49 we calculated the average annual percent changes (AAPC) and corresponding 95% confidence intervals (95% CI). The incidence analyses were stratified by sex, site (proximal colon, distal colon, rectum), age group (20-29, 30-39, and 40-49) and tumor size (T).
Results:
EO-CRC accounted for 5.1% (9529 cases) of all colorectal cancers in the selected German regions. The EO-CRC incidence rose annually by 1.16% (95% CI: [0.51; 1.81]) in men and 1.32% [0.80; 1.84] in women. The incidence of proximal colon cancer increased in both sexes (men: AAPC = 3.26 [2.00; 4.53]; women: AAPC = 2.99 [2.17; 3.83]), while the incidence of distal colon cancer remained unchanged.
Conclusion:
The incidence of EO-CRC in Germany is rising. The reasons are probably multifactorial, reflecting the changing prevalence of early life exposure to risk and protective factors.
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