Racial Disparities and Sex Differences in Early- and Late-Onset Colorectal Cancer Incidence, 2001-2018

• Published in: Frontiers in oncology Vol. 11; p. 734998
• Main Authors: Petrick, Jessica L, Barber, Lauren E, Warren Andersen, Shaneda, Florio, Andrea A, Palmer, Julie R, Rosenberg, Lynn
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 09.09.2021
• Subjects: early-onset colorectal cancer; joinpoint analysis; National Program of Cancer Registries (NPCR); neuroendocrine tumors; Oncology; racial disparities in cancer; Surveillance; and End Results (SEER) program; Surveillance; racial disparities in cancer; National Program of Cancer Registries (NPCR); Epidemiology; early-onset colorectal cancer; neuroendocrine tumors; joinpoint analysis
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2021.734998

Colorectal cancer (CRC) incidence rates have increased in younger individuals worldwide. We examined the most recent early- and late-onset CRC rates for the US. Age-standardized incidence rates (ASIR, per 100,000) of CRC were calculated using the US Cancer Statistics Database's high-quality population-based cancer registry data from the entire US population. Results were cross-classified by age (20-49 [early-onset] and 50-74 years [late-onset]), race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, American Indian/Alaskan Native, Asian/Pacific Islander), sex, anatomic location (proximal, distal, rectal), and histology (adenocarcinoma, neuroendocrine). During 2001 through 2018, early-onset CRC rates significantly increased among American Indians/Alaskan Natives, Hispanics, and Whites. Compared to Whites, early-onset CRC rates are now 21% higher in American Indians/Alaskan Natives and 6% higher in Blacks. Rates of early-onset colorectal neuroendocrine tumors have increased in Whites, Blacks, and Hispanics; early-onset colorectal neuroendocrine tumor rates are 2-times higher in Blacks compared to Whites. Late-onset colorectal adenocarcinoma rates are decreasing, while late-onset colorectal neuroendocrine tumor rates are increasing, in all racial/ethnic groups. Late-onset CRC rates remain 29% higher in Blacks and 15% higher in American Indians/Alaskan Natives compared to Whites. Overall, CRC incidence was higher in men than women, but incidence of early-onset distal colon cancer was higher in women. The early-onset CRC disparity between Blacks and Whites has decreased, due to increasing rates in Whites-rates in Blacks have remained stable. However, rates of colorectal neuroendocrine tumors are increasing in Blacks. Blacks and American Indians/Alaskan Natives have the highest rates of both early- and late-onset CRC. Ongoing prevention efforts must ensure access to and uptake of CRC screening for Blacks and American Indians/Alaskan Natives.