Colorectal Cancer Mortality Rates in Adults Aged 20 to 54 Years From 1970 to 2014

Key Points

  • Colorectal cancer mortality has decreased overall since 1970, despite a trend of increase since 2005.
  • The increase in colorectal cancer mortality is confined to an increase among white persons. 

In a research letter to JAMA, Siegel et al reported that overall colorectal cancer mortality rates have declined in the United States between 1970 and 2014 in patients aged 20 to 54 years but increased in white persons in this age group between 2004 and 2014.

Study Details

In the study, colorectal cancer mortality rates per 100,000 population, age-adjusted to the 2000 U.S. standard population, from 1970 through 2014 were obtained from SEER*Stat (version 8.3.4) for decedents who were aged 20 to 54 years, as reported by the National Center for Health Statistics.

Mortality Trends

Overall, colorectal cancer mortality per 100,000 population among individuals aged 20 to 54 years declined from 6.3 in 1970 to 3.9 in 2004 and then increased by 1.0% annually to 4.3 in 2014. This increase was confined to white individuals, for whom mortality rates increased by 1.4% annually from 3.6 in 2004 to 4.1 in 2014.

Mortality rates in black individuals decreased by 0.4% annually from 8.1 in 1970 to 6.1 in 2014. Mortality rates decreased in persons of other races combined by 1.1% annually between 1970 and 2006 and did not significantly change thereafter.

Analysis by Age

In an analysis by age, rates in white persons during the most recent trend period defined by Joinpoint regression were stable among those aged 20 to 29 years between 1988 and 2014, increased by 1.6% annually in those aged 30 to 39 years between 1995 and 2014, and increased by 1.9% annually in those aged 40 to 49 and by 0.9% annually in those aged 50 to 54 years between 2005 and 2014. Rates in black persons decreased between 1970 and 2014 by 2.1% annually in those aged 20 to 29 years and by 1.1% annually since 1993 in those aged 50 to 54 years.

The investigators noted that the identified mortality trends are consistent with reported colorectal cancer incidence between 1998 and 2009 among patients aged < 50 years, which was stable in black persons but increased in white persons by 1.5% annually for local-stage and regional-stage disease and by 3% annually for distant-stage disease, and that the disparate racial patterns observed are in conflict with trends in colorectal cancer risk factors such as obesity, which are similar in white and black individuals.

They concluded: “Escalating mortality rates in young and middle-aged adults highlight the need for earlier colorectal cancer detection through age-appropriate screening and more timely follow-up of symptoms.”

The study was supported by the American Cancer Society.

Rebecca L. Siegel, MPH, of the American Cancer Society, is the corresponding author of the JAMA article. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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