Early-Onset CRC Rises Despite Stable Overall Incidence in UK

TOPLINE: The overall incidence of colorectal cancer (CRC) in the United Kingdom plateaued at 67.4 per 100,000 person-years from 2000 to 2021, with slight improvements observed in overall survival, particularly in those aged 60-69 years; however, the incidence of early-onset CRC showed an increasing trend during the same period.

METHODOLOGY: Researchers performed a cohort study including 11,388,117 patients with CRC from the UK Clinical Practice Research Datalink GOLD database and repeated the study using the Aurum database (n = 24,340,860).Researchers determined incidence rates and short- and long-term survival, stratified on the basis of age, sex, and diagnosis year from 2000 to 2021.Participants aged 18 years or older with at least 1 year of prior history were followed up until the cancer outcome, exit from the database, death, or end of the study period (December 31, 2021, for GOLD; December 31, 2019, for Aurum), whichever came first.TAKEAWAY:Age-standardised incidence rates across the study period were 67.4 and 63.7 per 100,000 person-years for GOLD and Aurum, respectively. The rates were significantly higher in men than in women (83.0 vs 54.9 per 100,000 person-years; P < .001) for GOLD, with similar results observed for Aurum.Incidence rates across the study period increased with age; in GOLD, those aged 18-29 years had the lowest rates (0.77), whereas those aged 80-89 years had the highest rates (277.2). However, the incidence of CRC increased annually in those aged 30-59 years across both databases.For GOLD, the overall survival at 1, 5, and 10 years was 78.3%, 51.4%, and 38.5%, respectively, with women showing higher median survival than men (6.0 vs 5.1 years).One-year survival increased from 77.1% in 2000-2004 to 78.9% in 2015-2019, with 5-year survival increased from 48.9% to 52.0%.Those aged 60-69 years showed the most consistent improvements in survival, with 1-year survival increased from 80.7% in 2000-2004 to 85.8% in 2015-2019.IN PRACTICE:"In conclusion, our study shows a reduction in CRC incidence over the years, mostly driven by those aged 60-79 years, in whom consistent small survival improvements are observed, possibly associated with screening. The rising EOCRC [early-onset CRC] incidence raises the question of whether lowering the screening age could improve outcomes and highlights the need to better understand its biology and risk factors for more targeted screening," the authors wrote. SOURCE:This study was led by Patricia Pedregal-Pascual and Carlos Guarner-Argente, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. It was published online in The American Journal of Gastroenterology. LIMITATIONS:Researchers acknowledged several key limitations, including the lack of linkage to cancer registry data, which may have resulted in misclassification or delayed diagnoses. The use of primary care records prevented stratification on the basis of tumour histology, genetic mutations, staging, or cancer therapies, limiting the ability to account for differences in prognosis across subgroups. Additionally, factors such as socioeconomic status and ethnicity that may affect incidence, prevalence, and survival were not analysed. DISCLOSURES:This study received funding through a grant from the Innovative Medicines Initiative 2 Joint Undertaking. Additionally, this study received partial support from the National Institute for Health and Care Research Oxford Biomedical Research Centre. One author's research group reported receiving research grants from the European Medicines Agency, Innovative Medicines Initiative, Amgen, Chiesi, and UCB Biopharma and consultancy or speaker fees from Astellas, Amgen, AstraZeneca, and UCB Biopharma. Additional disclosures are noted in the original article. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.