The rate of intestinal cancer, also known as colorectal cancer or CRC, is increasing among adults aged 20 to 49 in Europe, research published in the journal suggests. 'Gut'. Rates increased more sharply among the youngest age group (20-29 years), and the authors caution that, if the trend continues, it is possible that screening patterns need to be reconsidered.
Rates tend to be lower among people over 50, but the opposite happens among younger adults in North America, Australia and China, the researchers say. And in the United States, the increase in new cases among people aged 20 to 40 years has led the American Cancer Society to recommend reducing the age at which the test begins at age 45.
During the last decade, the number of new cases of bowel cancer has increased in most European countries, but the situation of rates among younger adults is not clear. Then, to shed some light on European trends, a team of researchers analyzed data from national and regional cancer registers on the number of new cases and deaths related to bowel cancer between 1990 and 2016.
They used data from 143.7 million people aged 20 to 49 from 20 countries, including Germany, Sweden, the United Kingdom and the Netherlands. Between 1990 and 2016, a total of 187,918 people were diagnosed with bowel cancer and there was a more pronounced increase in the number of new cases in recent years.
Between 20 and 29 years of age, the incidence of bowel cancer increased from 0.8 to 2.3 cases per 100,000 people between 1990 and 2016, and the most pronounced increase was between 2004 and 2016, with a 7, 9 percent a year. For the group of 30 to 39 years, the incidence increased less pronounced than in the youngest age group, with an average of 4.9 percent per year from 2005 to 2016.
Eight countries with significant increases in youth
Finally, between the age group of 40 to 49 years, bowel cancer rates decreased by 0.8 percent between 1990 and 2004, but then increased slightly by 1.6 percent per year from 2004 to 2016. new cases of bowel cancer increased significantly among people aged 20 to 39 in 12 countries: Belgium, Germany, the Netherlands, the United Kingdom, Norway, Sweden, Finland, Ireland, France, Denmark, the Czech Republic and Poland; but talia showed a decrease in the number of cases.
In eight countries (United Kingdom, Greenland, Sweden, Slovenia, Germany, Finland, Denmark and the Netherlands), the number of cases rose significantly among young people aged 40 to 49 years, but the rates decreased significantly in the Czech Republic in the last years (1997-2015).
The number of deaths from colon cancer did not change significantly among younger adults (20-29 years), but decreased by 1.1 percent per year between 1990 and 2016 in the age group of 30 to 39 years and in 2.4 percent per year between 1990 and 2009 among people aged 40 to 49.
However, it is an observational study, and as such, can not establish the cause. In addition, the authors highlight some limitations, including the fact that data quality varies across countries and, in some cases, is only available for a limited number of regions. Several factors may be behind these trends, such as the increase in obesity and factors related to lifestyle, such as lack of physical activity, alcohol consumption and smoking, they write.
Bowel cancer in young adults is “partly due to hereditary cancer syndromes, but most cases are sporadic,” the authors add, members of the Department of Gastroenterology and Hepatology at the Medical Center of the University of Erasmus MC, in Rotterdam, the Netherlands.
They say it is too early to use their findings to support the reduction of the age of screening to 45 years in Europe, but if the trend continues, it is possible that the screening guidelines should be reconsidered. “Until the underlying cause of this trend is identified, it would be (a good idea) to increase the awareness of clinicians and identify the factors possibly associated with this trend,” they conclude.