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Increasing Trend in Young-Onset Colorectal Cancer in Asia

More Cancers in Men and More Rectal Cancers

Sung, Joseph J.Y., MD, PhD1; Chiu, Han-Mo, MD, PhD2; Jung, Kyu-Won, MD, MS3; Jun, Jae Kwan, MD, PhD4; Sekiguchi, Masau, MD, PhD5; Matsuda, Takahisa, MD, PhD5; Kyaw, Moe H., MBBS, MSc1

American Journal of Gastroenterology: February 2019 - Volume 114 - Issue 2 - p 322–329
doi: 10.14309/ajg.0000000000000133
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BACKGROUND: The incidence of young-onset colorectal cancer (CRC) is reported to be increasing in the Western world. There are no population-based studies assessing the trend across Asia.

METHODS: We performed a multinational cohort study involving four Asian countries/regions, namely Taiwan, Korea, Japan, and Hong Kong. The magnitude and direction of trend in the incidence of young-onset CRC (age < 50) were quantified using Joinpoint Regression Program to estimate average annual percentage change (AAPC).

RESULTS: In Taiwan (1995–2014), incidence of young-onset CRC significantly increased in both men (colon cancer: 4.9–9.7 per 100,000; rectal cancer: 4.0–8.3 per 100,000) and women (colon cancer: 5.1–9.7 per 100,000; rectal cancer: 3.8–6.4 per 100,000). In Korea (1999–2014), incidence of young-onset CRC significantly increased in both men (colon cancer: 5.0–10.4 per 100,000; rectal cancer: 4.9–14.0 per 100,000) and women (colon cancer: 4.1–9.6 per 100,000; rectal cancer: 4.1–9.1 per 100,000). The most pronounced change was observed with male rectal cancer, increasing by 3.9% per year in Taiwan (AAPC + 3.9, 95% confidence interval + 3.3 to +4.5, P < 0.05) and 6.0% per year in Korea (AAPC +6.0, 95% confidence interval + 4.5 to +7.6, P < 0.05). Only a significant increase in rectal cancer was noted in Japan (male rectal cancer: 7.2–10.1 per 100,000, female rectal cancer 4.7–6.7 per 100,000) and Hong Kong (male rectal cancer: 4.4–7.0 per 100,000).

CONCLUSIONS: Increasing trend in young-onset CRC is not limited to the Western world. This finding may have implications on screening program for CRC in these countries/regions.

1Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong;

2Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan;

3The Korea Central Cancer Registry, National Cancer Center, Seoul, Korea;

4National Cancer Control Institute, National Cancer Center, Seoul, Korea;

5Cancer Screening Division, National Cancer Center Hospital, Tokyo, Japan.

Correspondence: Joseph J. Y. Sung, MD, PhD. E-mail: jjysung@cuhk.edu.hk

Received May 23, 2018

Accepted November 29, 2018

© The American College of Gastroenterology 2019. All Rights Reserved.
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