CRC incidence jumps suddenly from ages 49 to 50 years

  • Abualkhair WH & al.
  • JAMA Netw Open
  • 3 Jan 2020

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • A Surveillance, Epidemiology, and End Results (SEER) database analysis shows a steep increase in colorectal cancer (CRC) incidence from age 49 to 50 years.

Why this matters

  • Previous age-block analyses missed the increase.
  • There may be a high case burden of preclinical, undetected early-onset CRC among younger individuals.

Study design

  • Retrospective analysis of 1-year age intervals (span, 30-60 years) of the SEER database (n=165,160 CRC cases; 55.9% men; 75.4% white).
  • Funding: None disclosed.

Key results

  • The largest increase in CRC incidence across any age transition was found between ages 49 and 50 years:
    • Rate ratio incidence, 1.46 (95% CI, 1.43-1.51).
    • Log-linear modeling suggested that advancing age would account for a 16.6% increase.
  • The age 49-50 years increase was found in all regions of the United States in both men and women, in white and black populations, and in both colon and rectal cancers.
  • The increase was seen for localized-stage disease (75.9% increase), regional-stage disease (30.3%), and distant-stage disease (15.7%).
  • Of CRCs diagnosed in patients aged 50 years, 92.9% were invasive.

Limitations

  • Retrospective analysis.