More Younger People Getting Later Stage Colon Cancer Interview with:

Dr. Reinier G. S. Meester, PhDPostdoctoral scholar in the Department of MedicineDivision of Gastroenterology and HepatologyStanford

Dr. Meester

Dr. Reinier G. S. Meester, PhD
Postdoctoral scholar in the Department of Medicine
Division of Gastroenterology and Hepatology
Stanford What is the background for this study? What are the main findings? 

Response: Incidence of colorectal cancer has increased for decades in adults under age 50 years in the United States. However, there is still uncertainty regarding the underlying causes of this increase.

We studied the patterns in the stage at diagnosis from cancer registry data to assess whether the increases may be due more common use of colonoscopy in the ages 40-49 years, which account for nearly 3 out of 4 young-onset cases. If the increase in incidence were the result of earlier detection from increased colonoscopy use, earlier stage at diagnosis would be expected, whereas if the increased incidence were the result of true rises in risk, relatively later stage at diagnosis would be expected.

Our results suggest that the incidence of late-stage (metastatic) colorectal cancer increased at almost twice the relative rate since 1995 (2.9% per year) compared to earlier stages (1.3-1.4% per year). Over 1 in 4 young-onset cases are now diagnosed at a late stage vs. approximately 1 in 5 cases in the 1990s. What should readers take away from your report?

Response: Incidence of colorectal cancer is not only increasing among adults aged 40-49 years in the United States since the 1990s, but the disease is also diagnosed at later stages. This suggests that the trends in incidence are due to real increases in risk, and not the increased use of colonoscopy. What recommendations do you have for future research as a result of this work? 

Response: More research is indicated on potential determinants of young-onset disease, with the ultimate aim to better prevent the disease and reverse trends. At this point, earlier adoption of colorectal cancer screening as recommended by the American Cancer Society may be the most promising prevention method. 


Meester RGS, Mannalithara A, Lansdorp-Vogelaar I, Ladabaum U. Trends in Incidence and Stage at Diagnosis of Colorectal Cancer in Adults Aged 40 Through 49 Years, 1975-2015. JAMA. 2019;321(19):1933–1934. doi:10.1001/jama.2019.3076


May 22, 2019 @ 10:53 am


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