Epidemiological Classification Changes and Incidence of Early-Onset Colorectal Cancer
Authors' conclusion
In this cohort study, the 2013 change in NENs classification had a prominent role in EOCRC incidence patterns. Public health decision-makers should consider this artifactual increase.
Study context
- Population
- Individuals newly diagnosed with invasive colorectal cancer 2004–2021, 7 French administrative areas; period covered 2013 change in NEN classification
- Participants
- 63,780 individuals
- Exposure
- Early-onset (<50 years) vs older patients, by histopathological type and tumor extension
- 15 to 39 yearsn = 935
- 40 to 49 yearsn = 2,333
- 50 years or oldern = 60,512reference
- Outcome
- Age-specific incidence rates of colorectal adenocarcinoma (ADC) and neuroendocrine neoplasms (NENs); Annual percent changes (APCs) from flexible multivariable Poisson model
Methodological detailspopulation-based cancer registries (FRANCIM), 7 French administrative areas, Statistical analysis November 2024 to March 2025
- Population-based cancer registries (FRANCIM)
- 7 French administrative areas
- Statistical analysis November 2024 to March 2025
Main finding
As reported in the abstract
Early-onset colorectal cancer (EOCRC) incidence, females aged 15 to 39 years: APC
2.9% (1.6%-4.3%) (95% CI)
EOCRC incidence, males aged 15 to 39 years: APC
2.6% (1.2%-4.0%) (95% CI)
EOCRC NEN increase 2004–2013, per year (95% CI)
between 10.1% (4.0%-16.5%) and 12.6% (7.2%-18.2%)
EOCRC NEN trend after 2013, per year (95% CI)
ranging from −1.1% (−1.9% to −0.2%) to −1.7% (−3.0% to −0.4%)
Observational data: associations, not effects.
Further findings
Proportion of NENs by age class
Proportion of neuroendocrine neoplasms (NENs) by age class
- NEN increase affected colorectal cancer incidence only for patients aged 15 to 39 years
EOCRC adenocarcinoma (ADC) M1 (distant metastasis) incidence · entire study period
- Increased in both sexes, per year (95% CI)
- between 1.2% (0.3%-2.1%) and 2.3% (1.0%-3.6%) between 2013 and 2021
Original publication
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