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August 23, 2025JNCI Journal of the National Cancer Institute17 citationsOpen Access

Increase of early-onset colorectal cancer: a cohort effect

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LDLaura DownhamMLMathieu LaversanneSPSandra Pérdomo

Key Points

  • Early-onset colorectal cancer incidence has increased significantly in recent decades across multiple countries.
  • Countries report varying annual percentage changes; Canada at 3.7% and England at 6.0%, highlighting regional differences.
  • Analysis utilizing age-period-cohort models reveals a clear cohort effect with rising risks for later generations.
  • Understanding these trends may point to early-life exposures that significantly contribute to cancer risk later in life.

Abstract

Abstract Increasing incidence rates of early-onset colorectal cancer (eoCRC, 50 years) have been reported across multiple countries. We investigated long-term cancer incidence data (from 1995 or earlier) from Australia, Canada, England, and the U.S, separately by sex. Estimated annual percentage change (EAPC) and age-period-cohort (APC) models were used to assess trends by country and sex. All countries showed increasing eoCRC incidence in successive birth cohorts since 1960, with those born in the 1990s facing at least five-fold higher risks than those born in the 1960s. Cohort effects were observed across all countries, with sharper increases at younger ages. Over the most recent decade, EAPC ranged from 3.7% in Canada to 6.0% in England, with steep rises before age of 40. The emergence of these trends from ages 20–29 suggests contributing factors may originate early in life and may reflect exposures whose effect begin in youth and accumulate throughout the lifespan.

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Cite This Study

Downham et al. (2025) studied this question.

synapsesocial.com/papers/68af59ddad7bf08b1eade96bhttps://doi.org/10.1093/jnci/djaf238
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