A recent retrospective study on colorectal cancer showed that there has been a trend towards more colorectal cancer in younger patients across Europe over the past 25 years. Could this hint that the guidelines for early detection of colorectal cancer need to be rewritten?
In this retrospective study, data from the years 1990 to 2016 from more than 143 million people from all over Europe were evaluated. All individuals were between 20 and 49 years old and thus below the 50th year of life required by many international guidelines for the early detection of colorectal cancer.
Surprisingly, the largest increase in colorectal cancer diagnosis was found in the 20-29 age group, followed by those under 39 years of age and finally 40-49 years of age. Cancer mortality decreased measurably in the groups 30-39 years (1.1% per year) and 40-49 years (2.4% per year).
A closer look at the data also revealed that the increase in colorectal cancer became measurable especially after the year 2000 and has increased steadily since then. In 1990 the rate for 20-29-year-olds was still 0.8 cases per 100,000. In 2016 it was already 2.3 cases per 100,000. The annual rate of increase also accelerated in this period from 1.7% in 1990 to 7.9% between 2004 and 2016.
If this trend continues, it may soon be necessary to rethink the current screening practice with an entry age of 50 years and, if necessary, to reduce it further.
Vuik FE et al., Gut 2019 [Epub ahead of print]: doi: 10.1136/gutjnl-2018-317592 PMID: 31097539