Colorectal cancer mortality rates increasing in younger white adults

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Colorectal cancer mortality rates are declining overall, but trends for all ages combined can mask patterns in young adults.
Colorectal cancer mortality rates are declining overall, but trends for all ages combined can mask patterns in young adults.

Colorectal cancer mortality rates have decreased in blacks aged 20 to 54 years since 1970, but have increased among whites aged 30 to 39 years since 1995 and among whites aged 40 to 54 years since 2005, according to research published in JAMA.

Although colorectal cancer mortality rates are declining overall, combined mortality trends for all ages can mask patterns in young adults. Therefore, Rebecca L. Siegel, MPH, Kimberly D. Miller, MPH, and Ahmedin Jemal, DVM, PhD, from the Surveillance and Health Services Research Program at the American Cancer Society in Atlanta, examined colorectal cancer mortality rates among individuals aged 20 to 54 years by race from 1970 through 2014.

A total of 242,637 people aged 20 to 54 years died from colorectal cancer from 1970 to 2014, with a median age of 49 years (54% male, 80% white, 17% black, 3% other race). Mortality rates in individuals aged 20 to 54 years declined from 6.3 per 100,000 persons in 1970 to 3.9 per 100,000 persons in 2004. After 2004, the rate increased annually by 1.0% to 4.3 per 100,000 persons in 2014.

The researchers note that this increase was confined to white individuals. Mortality rates among whites increased by 1.4% annually from 3.6 per 100,000 persons to 4.1 per 100,000 persons in 2014. Mortality rates among blacks declined by 0.4% annually to 1.1% annually, from 8.1 per 100,000 persons in 1970 to 6.1 per 100,000 persons in 2014.

Mortality rates decreased among blacks aged 20 to 49 years during the entire study period, and decreased in those aged 50 to 54 years since 1993. Mortality trends in whites aged 20 to 29 years were stable between 1988 and 2014. However, the rate increased by 1.6% annually for whites aged 30 to 39 years from 1995 to 2014, by 1.9% annually for those aged 40 to 49 years, and by 0.9% annually for those aged 50 to 54 years from 2005 to 2014.

“Although 5-year survival in persons aged 15 to 64 years has improved, mortality is a function of incidence and survival and can increase if increased [colorectal cancer] occurrence is of sufficient magnitude to outweigh improvements in survival,” the researchers noted. “Increased mortality is particularly unexpected among those aged 50 to 54 years, for whom screening has been recommended since the 1970s.

Reference

Siegel RL, Miller KD, Jemal A. Colorectal cancer mortality rates in adults aged 20 to 54 years in the United States, 1970-2014. JAMA. 2017;318(6):572-574.

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