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We read with interest the article titled ‘Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years’ by Vuik et al, in which they analysed trends in colorectal cancer (CRC) among young adults (20–49 years old) and found that CRC incidence is increasing among young adults in Europe.1 We have found that the incidence of CRC in young adults in Europe is significantly different from that in the USA.2 Therefore, we analysed the incidence of CRC in young adults with data from the Surveillance, Epidemiology and End Results database (from 1990 to 2016, a total of 78 295 cases, aged from 20 to 49 years) by the Joinpoint regression method and compared it with the results from Europe.
We found that the incidence of CRC in young adults in the USA increased annually, with an annual per cent change (APC) of 4.3% in the age group of 20–29 years, 2.47% in the age group of 30–39 years and 1.8% in the age group of 40–49 years (figure 1A–C). Although the incidence rate was increasing, the mortality rate had not changed significantly, which may be related to young adults presenting with more local or regional disease.3–5 We know little about the indications for colonoscopy in young adults, but studies have shown increases in colonoscopy use that parallel the incidence of CRC in young adults, which could explain the increasing …
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