Prevalence, Incidence of Early-Onset CRC Increased in Individuals Aged 40 to 49 Years

Early-onset colorectal cancer (EO-CRC) in individuals aged 40 to 49 years increased in prevalence and incidence globally between 1990 and 2019, according to a study published in the Journal of Cancer Research and Clinical Oncology. Disease burden was found to be heavy in numerous regions and countries.

CRC had the third-highest incidence and second-highest mortality of all cancers globally in 2018. EO-CRC is CRC diagnosed in patients younger than 50 years. A previous study had investigated the global, regional, and national burden and trends of EO-CRC from 1990 to 2019 but focused on all patients younger than 50 years, which is a broad range. This study aimed to use the data from the Global Burden of Disease Study 2019 Data Resources (GBD 2019) to explore the disease burden of EO-CRC in patients aged 40 to 49 years.

Gastroenterologist doctor, intestine specialist. Aesthetic handdrawn highlighted illustration of human intestine. Dark grey background, studio photo and collage. | Image Credit: mi_viri - stock.adobe.com

The GBD 2019 was used to extract data. Incidence, mortality, prevalence, and disability-adjusted life-years (DALYs) were the 4 indicators attributable to EO-CRC for individuals aged 40 to 49 years. DALYs were defined as “years of healthy life lost” calculated due to premature death and years lived with a disability. All 4 indicators had 95% uncertainty intervals (UIs). Sociodemographic index was used to evaluate the relationship between economic development of 204 countries and territories and the DALYs rate for EO-CRC. The Bayesian age-period-cohort was used for age-standardized rates.

There were 56,655 new cases of EO-CRC in individuals aged 40 to 44 years (95% UI, 51,800-62,133), 21,446 related deaths (95% UI, 19,763-23,201), 358,410 existing cases (95% UI, 328,025-392,373), and 1,035,331 DALYs (95% UI, 955,067-1,118,113) in 2019. Per 100,000 population, the rate of incidence was 11.48 (95% UI, 20.50-12.59), mortality was 4.35 (95% UI, 4.01-4.70), prevalence was 72.63 (95% UI, 66.48-79.52), and DALY was 209.82 (95% UI, 193.55-226.59). Global incidence and prevalence rate increased between 1990 and 2019 with estimated annual percentage changes (EAPCs) of 1.27 (95% CI, 1.16-1.37) and 1.80 (95% CI, 1.67-1.93), respectively. Overall rates of mortality and DALY remained stable.

In individuals aged 45 to 49 years, there were 92,991 incident cases of EO-CRC (95% UI, 85,138-102,046) and an incidence rate of 19.63 per 100,000 individuals (95% UI, 17.97-21.54). There were 36,748 (95% UI, 33,930-39,835) fatalities with a mortality rate of 7.76 per 100,000 (95% UI, 7.16-8.41). The prevalence rate was 121.73 per 100,000 (95% UI, 110.99-133.84). Global incidence and prevalence in people aged 45 ti 49 years increased from 1990 to 2019, with incidence increasing by 1.09% (95% CI, 0.99%-1.19%) and prevalence increasing by 1.56% (95% CI, 1.44%-1.68%). Mortality and DALY remained stable.

The highest incidence rate of EO-CRC in individuals aged 40 to 44 years was found in Taiwan, followed by Monaco and the United States. Taiwan, Portugal, and Monaco had the highest incidence rate in individuals aged 45 to 49 years. The globally projected age-standardized rate for incidence of EO-CRC in individuals aged 40 to 49 years is 18.42 per 100,000 in 2030, which would be an increase of 20.1% from 2019 to 2030. Mortality is also expected to increase by 3.5% from 2019 to 2030.

There were a couple limitations to this study. There was not a reasonable explanation found for the increase in incidence and prevalence of EO-CRC in individuals aged 40 to 44 years. The burden of EO-CRC in specific countries and regions was not as comprehensive as possible.

The researchers concluded that incidence and prevalence rates of EO-CRC increased in individuals in their 40s from 1990 to 2019.

Reference

Tang X, Peng J, Huang S, et al. Global burden of early-onset colorectal cancer among people aged 40-49 years from 1990 to 2019 and predictions to 2030. J Cancer Res Clin Oncol. Published online September 15, 2023. doi:10.1007/s00432-023-05395-6