Increase in Incidence of Colorectal Cancer Among Young Men and Women in the United States

The recent, accelerated decline in colorectal cancer incidence rates has largely been attributed to an increase in screening rates among adults 50 years and older. We used data from 13 Surveillance, Epidemiology, and End Results cancer registries to report on colorectal cancer incidence trends from 1992 through 2005 among adults under age 50 years, for whom screening is not recommended for persons at average risk, by sex, race/ethnicity, age, stage at diagnosis, and anatomic subsite. Overall, incidence rates of colorectal cancer per 100,000 young individuals (ages 20-49 years) increased 1.5% per year in men and 1.6% per year in women from 1992 to 2005. Among non-Hispanic Whites, rates increased for both men and women in each 10-year age grouping (20-29, 30-39, and 40-49 years) and for every stage of diagnosis. The increase in incidence among non-Hispanic Whites was predominantly driven by rectal cancer, for which there was an average increase of 3.5% per year in men and 2.9% per year in women over the 13-year study interval. In contrast to the overall decreasing trend in colorectal cancer incidence in the United States, rates are increasing among men and women under age 50 years. Further studies are necessary to elucidate causes for this trend and identify potential prevention and early detection strategies.