Maher Al Khaldi, Zubair Bayat, Noam Kahana, Michal Perets, Sameh Hany Emile
EOCRC incidence has accelerated markedly, accompanied by increasing mortality among younger adults. These trends underscore the need for earlier diagnosis, improved risk stratification, and equitable care.
BACKGROUND: Early-onset colorectal cancer (EOCRC) incidence is increasing despite declining rates among older adults. We evaluated long-term and recent EOCRC trends.
METHODS: SEER data (1975-2023) were analyzed for EOCRC incidence overall and by sex, race, and tumor site. A contemporary cohort (2019-2023) assessed stage and 3-year overall survival (OS).
RESULTS: EOCRC incidence accelerated during 2019-2023 (AAPC 8.3%), contrasting with declining incidence among adults ≥65 years. Mortality increased among individuals <50 years. Incidence rose faster among females than males (9.1% vs 7.6%) and for rectal versus colon cancer (9.0% vs 4.5%). Black patients more often presented with stage IV disease than White patients (33.9% vs 29.3%) and had lower 3-year OS (67.3% vs 76.2%).
CONCLUSIONS: EOCRC incidence has accelerated markedly, accompanied by increasing mortality among younger adults. These trends underscore the need for earlier diagnosis, improved risk stratification, and equitable care.