Demographic trends in the incidence of young-onset colorectal cancer in England:a population-based study, 1974-2015

BackgroundEvidence is emerging that colorectal cancer (CRC) incidence is increasing in young adults, but the descriptive epidemiology required to better understand these trends is currently lacking.MethodA population-based cohort study was carried out of all adults aged 20-49 years diagnosed with CRC in England between 1974 and 2015. Data were extracted from the NCRAS database using ICD9/10 codes for CRC. Temporal trends in age-specific incidence rates (IRs) according to gender, anatomical subsite, index of multiple deprivation (IMD) quintile and geographical region were analysed using Joinpoint regression.ResultsA total of 56 134 new diagnoses of CRC were analysed. The most sustained increase in IR was in the 20-29 age group which is mainly driven by a rise in distal tumours. The magnitude of IR increases was similar in both genders and across Index of Multiple Deprivation quintiles, although the most pronounced increases in incidence were in the southern regions of England. ConclusionCRC should no longer be considered a disease of older people: changes in incidence rates should be used to inform future screening policy, preventative strategies and research agendas, as well as increasing public understanding that younger people need to be aware of the symptoms of CRC.