Colorectal, Pancreatic Cancer Rising in Younger Adults

Researchers have identified a concerning rise in colorectal and pancreatic adenocarcinoma among younger adults, especially those aged 15 to 34 years, highlighting an urgent need for earlier recognition and screening in younger populations.1 The retrospective cohort study is published in JAMA Network Open.

New study reveals sharp increase in and colorectal and pancreatic cancer rates among Americans under 55 years, despite declines in older adults. | Image credit: lordn - stock.adobe.com

“In this cohort study, we analyzed data from the SEER [Surveillance, Epidemiology, and End Results] database examining the incidence of pancreatic and colorectal adenocarcinoma from 2000 to 2021,” the researchers of the study wrote. “In contrast to colorectal adenocarcinoma, which overall had a decreasing incidence, pancreatic adenocarcinoma appeared to be increasing among all age groups.”

Cancer has long been associated with older age, but a troubling trend of rising rates of early-onset cancers has emerged.2 Additionally, early-onset cancers may differ biologically from those in older adults, underscoring the urgent need for more research and tailored support for younger patients.

In this study, the researchers aimed to examine incidence trends for colorectal and pancreatic adenocarcinomas in the US, specifically focusing on annual percentage changes (APCs) in younger age groups.1

Incidence rates of colorectal and pancreatic adenocarcinoma per 100,000 population were obtained from the SEER database for the years 2000 to 2021. To maintain consistency and clinical relevance, rare pancreatic cancer subtypes with distinct biologic behaviors, such as squamous cell carcinoma, mucinous cystadenocarcinoma, solid pseudopapillary carcinoma, serous cystadenocarcinoma, pancreatoblastoma, and neuroendocrine tumors, were excluded from the analysis.

Between 2000 and 2021, a total of 1,215,200 CRC cases were identified, with 52.8% male (641,776) and 80.4% (976,716) aged 55 years or older. The APC for CRC significantly declined in those aged 55 and older (−3.31; 95% CI, −3.54 to −3.08), while it increased among younger individuals, with an APC of 1.75 (95% CI, 1.08-2.42; P = .001) for those aged 15 to 34 years and 0.78 (95% CI, 0.51 to 1.06; P = .002) for those aged 35 to 54 years.

For pancreatic adenocarcinoma, 275,273 cases were identified. The APC in pancreatic adenocarcinoma incidence was highest among individuals aged 15 to 34 years, at 4.35 (95% CI, 2.03-6.73), which was significantly greater than the APCs observed in the 55 and older group (1.74; 95% CI, 1.59-1.89; P = .007) and the 35 to 54 group (1.54; 95% CI, 1.18-1.90; P = .004).

However, the researchers acknowledged several study limitations. One main limitation of this study is that the SEER database represents approximately 47.9% of the US population, which may not capture all regional or demographic variations. However, SEER is specifically designed to provide reliable and generalizable estimates of cancer incidence trends across the broader US population. Previous studies have demonstrated that SEER coding is highly reliable for common cancers, including pancreatic and colorectal adenocarcinoma, though it may be less consistent for rarer tumor types.

Irrespective of limitations, the researchers believe the study highlights a concerning trend of increasing incidence of colorectal adenocarcinoma in the youngest age group and increasing pancreatic adenocarcinoma in all age groups.

“Heightened awareness of this trend is necessary when evaluating younger patients with possible corresponding symptoms,” the researchers wrote.

References

1. Bussetty A, Shen J, Benias PC, Ma M, Stewart M, Trindade AJ. Incidence of pancreas and colorectal adenocarcinoma in the US. JAMA Netw Open. 2025;8(4):e254682. doi:10.1001/jamanetworkopen.2025.4682

2. Katella K. What to know about rising rates of 'early-onset' cancer. Yale Medicine. Updated August 1, 2024. Accessed April 17, 2025. https://www.yalemedicine.org/news/early-onset-cancer-in-younger-people-on-the-rise