Mortality rates for early-onset CRC on the rise: 8 things to know

The mortality rate of early-onset colorectal cancer has increased over the last two decades, with those aged 20-44 years experiencing the most pronounced impact, Medscape Medical News reported Oct. 27.

The findings come from an analysis of the CDC's National Center for Health Statistics and the Surveillance, Epidemiology and End Results databases. The analysis found that early-onset CRC cases are driven primarily by the 20-44-year-old cohort.

The study was presented by Yazan Abboud, MD, internal medicine physician and chair of resident research at Rutgers New Jersey Medical School in Newark, at the 2024 American College of Gastroenterology Annual Scientific Meeting.

Here are eight more findings from the study:

1. The researchers collected age-adjusted mortality rates for EO-CRC between 2000 and 2022 from the NCHS database, as well as stage-specific, incidence-based mortality rates between 2004 and 2020 from the SEER 22 database. The researchers divided patients into two cohorts by age, one aged 20-44 years and the other 45-54 years, and by tumor stage, with cohorts for early- and late-stage tumors. They compared the annual percentage change between the two groups and assessed trends for the entire cohort of patients aged 20-54 years.

2. There were 147,026 total deaths in the NCHS database resulting from EO-CRC, 27% of which occurred in those 20-44 years old.

3. Mortality rates decreased between 2000-2005 in all ages included in the study but increased from 2005-2022.

4. Mortality also decreased between 2000-2005 in the 45-54-year-old cohort and increased in subsequent years.

5. There were 4,642 deaths among those with early-stage tumors across all age groups in the SEER 22 database. Mortality among these patients increased in the 45-54 cohort, but the 20-44 cohort saw insufficient numbers to determine this outcome.

6. Researchers observed increased mortality in those with late-stage tumors across all age groups in the SEER 22 database.

7. David Johnson, MD, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, told Medscape Medical News the findings indicate a need for more evidence-based means of identifying younger individuals with a high risk for EO-CRC.

8. Dr. Johnson, who was not involved in the study, noted that it could be promising to evaluate whether cancers in the younger cohort were more aggressive biologically or whether younger  patients tended to dismiss early signs of symptoms, such as overt bleeding and iron deficiency.

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