Early-Onset Colorectal Cancer (CRC) Cases Are Rising Globally

New data indicate that the incidence of early-onset colorectal cancer (CRC) is increasing worldwide. Researchers found that in the last decade, the incidence of early-onset CRC has risen in 27 of the 50 countries and territories analyzed. These findings were published in The Lancet Oncology.

Researchers analyzed data from the Cancer Incidence in Five Continents Plus database to determine age-standardized incidence rates (ASR) of early- and late-onset CRC diagnosed between 1943-2003 and 2015-2017. The primary objective of the study was to compare CRC incidence trends in younger adults (25-49 years) and older adults (50-74 years) across 50 countries and territories.

Highest CRC Incidence Rates by Country

Over the past 5 years, the highest incidence rates of early-onset CRC were observed in:

• Australia (ASR, 16.5)
• Puerto Rico (ASR, 15.2)
• New Zealand (ASR, 14.8)
• United States (ASR, 14.8)
• South Korea (ASR, 14.3)

Meanwhile, the highest incidence rates of late-onset CRC were recorded in:

• Netherlands (ASR, 168.4)
• Denmark (ASR, 158.3)
• Japan (ASR, 156.0)
• Spain (ASR, 148.2)
• Croatia (ASR, 146.8)

Trends in the Last Decade

In the past decade, early-onset CRC incidence increased in 27 countries and remained stable in 23. The highest annual percentage increases were observed in:

• New Zealand (3.97%)
• Chile (3.96%)
• Puerto Rico (3.81%)
• England (3.59%)

In 14 of the 27 countries where early-onset CRC incidence increased, the incidence of late-onset CRC either remained stable (Argentina, France, Ireland, Norway, and Puerto Rico) or declined (Australia, Canada, Germany, Israel, New Zealand, Slovenia, England, Scotland, and the United States).

Both early- and late-onset CRC incidence increased in 13 countries. The rate of increase was similar between the two groups in:

• Belarus (3.24% vs 1.95%)
• Ecuador (2.10% vs 1.76%)
• Turkey (2.15% vs 1.83%)

In some countries, the increase in late-onset CRC was greater than in early-onset CRC:

• Costa Rica (2.38% vs 1.49%)
• Denmark (2.40% vs 1.67%)
• Martinique (3.85% vs 1.74%)
• Thailand (3.77% vs 2.76%)

Conversely, in some countries, the increase in early-onset CRC was greater than in late-onset CRC:

• Chile (3.96% vs 1.55%)
• Croatia (1.39% vs 0.80%)
• Finland (0.89% vs 0.61%)
• Japan (2.94% vs 2.03%)
• Netherlands (1.77% vs 1.25%)
• Sweden (2.32% vs 0.34%)

A Global Health Concern

Researchers concluded:

"The increase in early-onset colorectal cancer, previously observed primarily in high-income Western countries, has now been documented across different economies and regions worldwide, making it a global phenomenon. Therefore, there is an urgent need for global initiatives and international collaborations to identify the causes of early-onset CRC and develop effective preventive strategies aligned with local resources and cultures."

Conflicts of Interest & Funding

This study was supported by the American Cancer Society. The study authors reported no conflicts of interest.