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Accelerating rise in early-onset colorectal cancer in the United States: Updated SEER trends through 2023
Maher Al Khaldi1, Zubair Bayat1, Noam Kahana2
1Colorectal Surgery Department, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, United States.
Background:
Early-onset colorectal cancer (EOCRC) incidence is increasing despite declining rates among older adults. We evaluated long-term and recent EOCRC trends.
Methods:
SEER data (1975-2023) were analyzed for EOCRC incidence overall and by sex, race, and tumor site. A contemporary cohort (2019-2023) assessed stage and 3-year overall survival (OS).
Results:
EOCRC incidence accelerated during 2019-2023 (AAPC 8.3%), contrasting with declining incidence among adults ≥65 years. Mortality increased among individuals <50 years. Incidence rose faster among females than males (9.1% vs 7.6%) and for rectal versus colon cancer (9.0% vs 4.5%). Black patients more often presented with stage IV disease than White patients (33.9% vs 29.3%) and had lower 3-year OS (67.3% vs 76.2%).
Conclusions:
EOCRC incidence has accelerated markedly, accompanied by increasing mortality among younger adults. These trends underscore the need for earlier diagnosis, improved risk stratification, and equitable care.
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