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. 2021 Sep 9:11:734998.
doi: 10.3389/fonc.2021.734998. eCollection 2021.

Racial Disparities and Sex Differences in Early- and Late-Onset Colorectal Cancer Incidence, 2001-2018

Jessica L Petrick  1 , Lauren E Barber  1   2 , Shaneda Warren Andersen  3   4 , Andrea A Florio  5 , Julie R Palmer  1 , Lynn Rosenberg  1
Affiliations

Racial Disparities and Sex Differences in Early- and Late-Onset Colorectal Cancer Incidence, 2001-2018

Jessica L Petrick et al. Front Oncol. .

Abstract

Background: Colorectal cancer (CRC) incidence rates have increased in younger individuals worldwide. We examined the most recent early- and late-onset CRC rates for the US.

Methods: Age-standardized incidence rates (ASIR, per 100,000) of CRC were calculated using the US Cancer Statistics Database's high-quality population-based cancer registry data from the entire US population. Results were cross-classified by age (20-49 [early-onset] and 50-74 years [late-onset]), race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, American Indian/Alaskan Native, Asian/Pacific Islander), sex, anatomic location (proximal, distal, rectal), and histology (adenocarcinoma, neuroendocrine).

Results: During 2001 through 2018, early-onset CRC rates significantly increased among American Indians/Alaskan Natives, Hispanics, and Whites. Compared to Whites, early-onset CRC rates are now 21% higher in American Indians/Alaskan Natives and 6% higher in Blacks. Rates of early-onset colorectal neuroendocrine tumors have increased in Whites, Blacks, and Hispanics; early-onset colorectal neuroendocrine tumor rates are 2-times higher in Blacks compared to Whites. Late-onset colorectal adenocarcinoma rates are decreasing, while late-onset colorectal neuroendocrine tumor rates are increasing, in all racial/ethnic groups. Late-onset CRC rates remain 29% higher in Blacks and 15% higher in American Indians/Alaskan Natives compared to Whites. Overall, CRC incidence was higher in men than women, but incidence of early-onset distal colon cancer was higher in women.

Conclusions: The early-onset CRC disparity between Blacks and Whites has decreased, due to increasing rates in Whites-rates in Blacks have remained stable. However, rates of colorectal neuroendocrine tumors are increasing in Blacks. Blacks and American Indians/Alaskan Natives have the highest rates of both early- and late-onset CRC.

Impact: Ongoing prevention efforts must ensure access to and uptake of CRC screening for Blacks and American Indians/Alaskan Natives.

Keywords: Epidemiology; National Program of Cancer Registries (NPCR); Surveillance; and End Results (SEER) program; early-onset colorectal cancer; joinpoint analysis; neuroendocrine tumors; racial disparities in cancer.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Age-adjusted early-onset (20-49 years of age) colorectal cancer incidence rates per 100,000 person-years in (A) men and (B) women, US Cancer Statistics 2001-2018.
Figure 2
Figure 2
Colorectal cancer male-to-female (M/F) incidence rate ratios by age and subsite, US Cancer Statistics 2001-2018.
See this image and copyright information in PMC

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