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Original article
Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years
  1. Fanny ER Vuik1,
  2. Stella AV Nieuwenburg1,
  3. Marc Bardou2,3,
  4. Iris Lansdorp-Vogelaar2,
  5. Mário Dinis-Ribeiro4,5,
  6. Maria J Bento6,
  7. Vesna Zadnik7,
  8. María Pellisé8,
  9. Laura Esteban9,
  10. Michal F Kaminski10,11,12,
  11. Stepan Suchanek13,
  12. Ondřej Ngo14,15,
  13. Ondřej Májek14,15,
  14. Marcis Leja16,
  15. Ernst J Kuipers1,
  16. Manon CW Spaander1
  1. 1 Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
  2. 2 Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
  3. 3 Centre d’investigations Clinique INSERM 1432, CHU Dijon-Bourgogne, Dijon, France
  4. 4 Gastroenterology, Portuguese Oncology Institute of Porto, Porto, Portugal
  5. 5 CINTESIS, Porto Faculty of Medicine, University of Porto, Porto, Portugal
  6. 6 North Region Cancer Registry (RORENO), Department of Epidemiology, Portuguese Oncology Institute of Porto, Porto, Portugal
  7. 7 Epidemiology and Cancer Registry, Institute of Oncology, Ljubljana, Slovenia
  8. 8 Gastroenterology Department, Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
  9. 9 Catalan Cancer Plan, Catalan Institute of Oncology, L’Hospitalet del Llobregat, Barcelona, Spain
  10. 10 Cancer Prevention, The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
  11. 11 Gastroenterology, Hepatology and Clinical Oncology, Medical Centre for Postgraduate Education, Warsaw, Poland
  12. 12 Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
  13. 13 Internal Medicine, 1st Faculty of Medicine, Charles University, Military University Hospital, Prague, Czech Republic
  14. 14 Faculty of Medicine, Masaryk University, Institute of Biostatistics and Analyses, Brno, Czech Republic
  15. 15 Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
  16. 16 Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
  1. Correspondence to Dr Manon CW Spaander, Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam 3015CE, The Netherlands ; v.spaander{at}erasmusmc.nl

Abstract

Objective The incidence of colorectal cancer (CRC) declines among subjects aged 50 years and above. An opposite trend appears among younger adults. In Europe, data on CRC incidence among younger adults are lacking. We therefore aimed to analyse European trends in CRC incidence and mortality in subjects younger than 50 years.

Design Data on age-related CRC incidence and mortality between 1990 and 2016 were retrieved from national and regional cancer registries. Trends were analysed by Joinpoint regression and expressed as annual percent change.

Results We retrieved data on 143.7 million people aged 20–49 years from 20 European countries. Of them, 187 918 (0.13%) were diagnosed with CRC. On average, CRC incidence increased with 7.9% per year among subjects aged 20–29 years from 2004 to 2016. The increase in the age group of 30–39 years was 4.9% per year from 2005 to 2016, the increase in the age group of 40–49 years was 1.6% per year from 2004 to 2016. This increase started earliest in subjects aged 20–29 years, and 10–20 years later in those aged 30–39 and 40–49 years. This is consistent with an age-cohort phenomenon. Although in most European countries the CRC incidence had risen, some heterogeneity was found between countries. CRC mortality did not significantly change among the youngest adults, but decreased with 1.1%per year between 1990 and 2016 and 2.4% per year between 1990 and 2009 among those aged 30–39 years and 40–49 years, respectively.

Conclusion CRC incidence rises among young adults in Europe. The cause for this trend needs to be elucidated. Clinicians should be aware of this trend. If the trend continues, screening guidelines may need to be reconsidered.

  • colorectal cancer
  • epidemiology
  • screening

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/gutjnl-2018-317592

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    Footnotes

    • Contributors FV: acquisition of data; analysis and interpretation of data, statistical analysis, drafting of the manuscript, critical revision of the manuscript for important intellectual content. SAVN: acquisition of data; analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content. MB: acquisition of data, critical revision of the manuscript for important intellectual content, study supervision. IL-V: critical revision of the manuscript for important intellectual content. MDR, MJB, VZ, MP, LE, MFK, SS, ON, OM, ML: acquisition of data, critical revision of the manuscript for important intellectual content. EJK: critical revision of the manuscript for important intellectual content, study supervision. MCWS: study concept and design, drafting of the manuscript, critical revision of the manuscript for important intellectual content, study supervision.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Correction notice This article has been corrected since it first published online. The open access licence type has been amended.

    • Patient consent for publication Not required.