番茄社区

Prior to current colorectal cancer (CRC) screening recommendations, incidence of young-onset CRC was estimated to increase by 20% to 30% by 2027, a researcher said.

Modeler analyses based on 56,000 cases of CRC among adults ages 45 to 50 from 2004 to 2017 projected an 11.4% increase in colon cancer by 2022 (n=3,249, 95% CI 3,072-3,425) and a 21.2% increase in incidence by 2027 (n=3,535, 95% CI 3,354-3,716), reported Deborah S. Keller, MD, MS, of the University of California at Davis Medical Center in Davis.

These analyses also projected an 11.6% increase in rectal cancer by 2022 (n=1,315, 95% CI 1,196-1,434) and a 28.6% increase in incidence (n=1,451, 95% CI 1,328-1,574) by 2027, she stated in a presentation at the virtual meeting.

"We have to make sure these patients actually get screened, or these numbers could be a reality," Keller said. "The onset of colorectal cancer has become a public health crisis."

In October 2020, the U.S. Preventive Services Task Force recommended beginning CRC screening at age 45, which aligned their guidelines with the American Cancer Society. The American College of Gastroenterology (ACG) also changed their guidelines in March 2021.

"This lends further data to support the lowering of the screening age for CRC [colorectal cancer] to 45 for both sexes and all ethnicities," Andrew E. Hendifar, MD, of Cedars-Sinai Medical Center in Los Angeles, who was not involved in this study, told 番茄社区.

Keller and colleagues cited steadily increasing rates of young-onset colorectal cancer among individuals in the U.S. ages 45 to 50, who also had "high rates of advanced stage disease at diagnosis."

"It's important to quantify how many colorectal cancer cases can be potentially detected if the screening age recommendations are appropriately followed," Keller added, saying that use of this information could project future cases or cases "that could be saved by early detection from screening."

The group evaluated data from the National Cancer Database among colorectal adenocarcinoma patients ages 40 to 50 from 2004 to 2017. Overall, 56,130 CRC cases were identified and stratified based on site. Of these, 65% of these cases were in the colon, 25% in the rectum and 10% in the rectosigmoid junction.

Primary outcome assessed CRC time trends by site and the estimation of potential cases forecasted without screening.

Men accounted for over half of all cases, with the majority being white. A large majority (85.9%) had no additional comorbidities, Keller said.

Notably, 32% of cases were Stage III, while 23% were Stage IV.

Modeling analyses also examined projected increases in 5-year and 10-year incidence rates for colon and rectal cancer, and found that without intervention, 5-year incidence would increase 111.4% and 111.6%, respectively, while 10-year incidence would increase 121.2% and 128.6%.

Keller explained that without intervention, cases in racial/ethnic minorities may account for the rise in CRC cases.

"The greatest increase [in CRC incidence] will be seen in new patients and it is estimated to be a remarkable increase in a lot of races -- Asian or Pacific Islanders, Alaskan Natives, and American Indians," Keller said.

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