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Early-Onset CRC Incidence Examined by Histologic Subtype

MONDAY, Dec. 21, 2020 -- Among individuals with early-onset colorectal cancer (EOCRC), adenocarcinoma rates are increasing in specific subgroups, but carcinoid tumors are increasing more steeply in all age groups, according to a study published online Dec. 15 in the Annals of Internal Medicine.

Eric M. Montminy, M.D., from the Tulane University School of Medicine in New Orleans, and colleagues examined the incidence rates (IRs) of EOCRC and changes in IR over time in a retrospective analysis using Surveillance, Epidemiology, and End Results 18 data from 2000 to 2016 for 119,624 patients with CRC.

The researchers found that the steepest changes in adenocarcinoma three-year moving average IRs were seen for rectal-only cases in those aged 20 to 29 and 30 to 39 years and colon-only cases in those aged 30 to 39 years (+39, +39, and +20 percent, respectively), corresponding to annual percent changes of 1.6, 2.2, and 1.2 percent, respectively. The three-year moving average IRs increased in colon-only and rectal-only subsites among those aged 40 to 49 years (+13 and +16 percent, respectively). Carcinoid tumors were common and accounted for 4 to 20 percent of colorectal cancer cases and 8 to 34 percent of rectal cancer cases. Colon-only carcinoid tumors were rarely observed. In all age groups, colorectal carcinoid tumor IRs increased more steeply than adenocarcinomas.

"These findings underscore the importance of assessing histologic CRC subtypes independently," the authors write. "This approach may lead to a better understanding of the drivers of temporal changes in overall CRC incidence."

Two authors disclosed financial ties to Exact Sciences, a molecular diagnostics company.

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Posted: December 2020

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