PHILADELPHIA — A concerning trend has emerged over the past two decades, revealing a significant rise in the mortality rate associated with early-onset colorectal cancer (EO-CRC) across the United States, particularly affecting individuals aged 20 to 44, as indicated by a recent comprehensive analysis of the two largest mortality databases in the country.
Recent findings from the US Centers for Disease Control and Prevention’s National Center of Health Statistics (NCHS) and the Surveillance, Epidemiology, and End Results (SEER) databases underscore the alarming and increasing prevalence of EO-CRC, which affects patients diagnosed with colorectal cancer before reaching the age of 50.
These findings “prompt tailoring further efforts toward raising awareness of colorectal cancer symptoms and keeping a low clinical suspicion in younger patients presenting with anemia, gastrointestinal bleeding, or change in bowel habits,” stated Yazan Abboud, MD, an internal medicine PGY-3, assistant chief resident, and chair of resident research at Rutgers New Jersey Medical School, in comments made to Medscape Medical News.
Abboud presented these crucial findings (Abstract P3865) during the prestigious American College of Gastroenterology (ACG) 2024 Annual Scientific Meeting, highlighting the urgent need for medical communities to address this growing health crisis.
Rising rates of EO-CRC have prompted US medical societies to recommend reducing the screening age to 45 years, reflecting the growing concern surrounding this demographic. The US Preventive Services Task Force made a landmark decision to officially lower the screening age to this threshold in 2021, a move that is supported by real-world evidence showing that early detection through screening significantly reduces the risk associated with colorectal cancer.
The researchers meticulously gathered age-adjusted mortality rates for EO-CRC spanning from 2000 to 2022 from the NCHS database. Additionally, they extracted stage-specific incidence-based mortality rates between 2004 and 2020 from the SEER 22 database, which comprehensively covers approximately 100% of the US population, while the SEER 22 database captures around 42% of cases.
In total, the NCHS database reported 147,026 deaths related to EO-CRC across all ages, with 27% (39,746) of these fatalities occurring in individuals aged 20-44 years. Notably, although mortality rates declined between 2000 and 2005 across all demographics (APC = -1.56), a troubling increase has been observed from 2005 to 2022 (APC = 0.87), raising concerns within the medical community.
In the SEER 22 database, there were 4,652 deaths recorded for individuals with early-stage tumors across all age brackets (average APC = 12.17). The mortality rate was particularly pronounced in patients aged 45-54 years with early-stage tumors (average APC = 11.52), although data for those aged 20-44 was insufficient to draw conclusions in this area.
There were 42,120 deaths in those with late-stage tumors across all studied age groups (average APC = 10.05) in the SEER 22 database, indicating a stark reality. Increased mortality was observed among those suffering from late-stage tumors in both age cohorts: 45-54 years (average APC= 9.58) and 20-44 years (average APC = 11.06).
“When evaluating the SEER database and stratifying the tumors by stage at diagnosis, we demonstrated increasing mortality of early-onset colorectal cancer in both early- and late-stage tumors on average over the study period,” Abboud remarked, emphasizing the urgent need for heightened awareness and intervention.
Commenting for Medscape Medical News, David A. Johnson, MD, a professor of medicine and chief of gastroenterology at Eastern Virginia School of Medicine, emphasized the necessity for evidence-based strategies to identify younger individuals who may be at a higher risk of developing EO-CRC.
“I suspect many younger patients with CRC had their cancer detected when it was more advanced due to delayed presentation and diagnostic testing,” acknowledged Johnson, who was not involved in the study, highlighting a significant public health concern.
Future research is needed to investigate the role of neoadjuvant chemotherapy in younger patients with early-stage colorectal cancer and evaluate patients’ outcomes,” Abboud added, pointing toward crucial areas for ongoing investigation and understanding.
The study had no specific funding. Abboud reported no relevant financial relationships. Johnson reported serving as an advisor to ISOTHRIVE. He is also on the Medscape Gastroenterology editorial board.
John Watson is a freelance writer in Philadelphia.
Rising Mortality Rate of Early-Onset Colorectal Cancer: What’s Going On?
Well, well, well, it looks like colorectal cancer is crashing the party earlier than ever, and the statistics are not pretty. In a recent analysis of mortality rates, early-onset colorectal cancer (EO-CRC) has shown a considerable uptick in fatalities across the United States over the past two decades. What’s particularly concerning is that this spike has been most pronounced in young adults aged 20-44. Yes, you heard that right—right in the age group typically busy thinking about their next avocado toast rather than their gastrointestinal health.
The Numbers Don’t Lie
According to data from the US Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) and the Surveillance, Epidemiology, and End Results (SEER) databases, it seems we’re dealing with a rising prevalence of EO-CRC, where cancer rears its ugly head in patients under 50. In fact, a whopping 27% of colorectal cancer-related deaths in this study were in the 20-44 age range. So, it appears binge-watching Netflix while ignoring potential health issues has its consequences after all.
What’s Behind This Surge?
Experts like Dr. Yazan Abboud—who presented these chilling findings at the American College of Gastroenterology’s 2024 Annual Scientific Meeting—are raising their voices about the urgent need to tailor awareness campaigns around colorectal cancer symptoms. Why? Because younger patients are often presenting late with symptoms that could have been identified much earlier. Think anemia, gastrointestinal bleeding, or just the classic symptoms of “my belly is not behaving”—all things that might warrant a visit to your friendly neighborhood doctor.
Something’s Not Quite Right
Rising rates of EO-CRC have prompted a significant shift in screening guidelines, with the US Preventive Services Task Force officially lowering the recommended screening age to 45 in 2021. Let’s put that into context: we can have existential crises in our thirties, but we couldn’t get screened for a potentially deadly disease until we were almost half a century old? Honestly, the system needs a bit of a “crack down,” not unlike a comedian in a room full of pointedly cold audience members.
The Study at a Glance
Let’s dig into the nitty-gritty. Abboud and co. analyzed age-adjusted mortality rates of EO-CRC for the years 2000-2022. Guess what? They found increasing mortality rates across all patient groups (aged 20-54)—whether they were facing early or late stages of cancer. You’d think with all the technological advancements, we wouldn’t still be in the dark about something as crucial as this. In fact, the mortality rate increased from 2005 to 2022. Not exactly the news you want printed on a birthday card, is it?
Calling Out Ignored Symptoms
David A. Johnson, MD, chief of gastroenterology at Eastern Virginia School of Medicine, weighed in on the findings too. He suspects that many younger patients may be dismissive of early warning signs. You know the type—brushing off symptoms like they brush off getting out of bed at a respectable hour. He pointed out, quite astutely, that symptoms like overt bleeding and iron deficiency should not be taken lightly. So, check your ensemble of “hey, it’s not that bad,” because ignorance is not bliss when it comes to health.
What’s Next?
The future is evidently calling for more research. Is EO-CRC in younger patients more aggressive biologically or are we simply ignoring the signs? It’s a bit of a mystery, and who knows, maybe we’ll need a real investigative journalist, or at least someone keen on asking the right questions, to crack the case. With rising numbers, awareness is key, and decisions need to be made—like opting for a fiber-rich diet instead of that third slice of cake.
So there you have it. Colorectal cancer is turning up earlier in life than your friend’s father’s terrible jokes, and we need to pay attention. It’s time to stop ignoring those cheeky little symptoms—that’s the kind of thing that could lead to unwelcome surprises. So, folks, keep your doctors on speed dial and maybe consider booking that screening appointment sooner rather than later. After all, nobody wants to be another statistic in this grim tale.
This study had no specific funding, which is the medical equivalent of, “Yeah, I didn’t study for this—winging it!” So buckle up, young ones. Take charge of your health before your laughter is the only thing that keeps you company.
