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Change in onset age of first primary colorectal cancer in the USA

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Abstract

Purpose

Identifying the onset age of cancer is essential for its early intervention. The aim of this study was to characterize the features and investigate the variation tendency of first primary colorectal cancer (CRC) onset age in the USA.

Methods

For this retrospective population-based cohort analysis, data on patients diagnosed with first primary CRC (n = 330,977) between 1992 and 2017 were obtained from the Surveillance, Epidemiology, and End Results dataset. Annual percent changes (APC) and average APCs were calculated to examine the changes in average age at CRC diagnosis using the Joinpoint Regression Program.

Results

From 1992 to 2017, the average age at CRC diagnosis decreased from 67.0 to 61.2 years, declining by 0.22% and 0.45% annually before and after 2000. The age at diagnosis was lower in the distal than in the proximal CRC cases and the age has the downward trends in all subgroups of sex, race, and stage. Over one-fifth of CRC patients were initially diagnosed with distantly metastatic CRC, with the age lower than that in localized CRC cases (63.5 vs 64.8 years).

Conclusions

The first primary CRC onset age has decreased significantly in the USA over the last 25 years and the modern lifestyle may be responsible for the decline. Specifically, the age of proximal CRC is invariably higher than that of distal CRC. Moreover, the age of advanced stage is lower than that of the early stage. Clinicians should adopt earlier screening age and more effective screening techniques for CRC.

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Data availability

All the data used in this study can be accessed from the SEER program (https:// seer. cancer. gov/).

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Funding

This research was supported by the National Natural Science Foundation of China (grant number 82000561 to H. Chu; grant number 81974062 and 81720108006 to X. Hou), Department of Science and Technology, Hubei Provincial People’s Government (grant number 2020FCA014 to X. Hou), and the Science Foundation of Union Hospital (grant number 2021xhyn005 to H. Chu).

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Author notes

  1. Ao Liu, Yongqiang Zheng, and Pengcheng Yang are co-first authors.

Authors and Affiliations

  1. Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Ao Liu, Pengcheng Yang, Huikuan Chu & **aohua Hou

  2. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, 510060, China

    Yongqiang Zheng

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Contributions

Conception and design: Huikuan Chu, **aohua Hou. Analysis and interpretation of data: Ao Liu, Yongqiang Zheng, Pengcheng Yang. Writing, review, and revision of the manuscript: Ao Liu, Yongqiang Zheng, Pengcheng Yang. All authors read and approved the final manuscript.

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Liu, A., Zheng, Y., Yang, P. et al. Change in onset age of first primary colorectal cancer in the USA. Int J Colorectal Dis 38, 45 (2023). https://doi.org/10.1007/s00384-023-04336-6

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