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Colorectal cancer statistics, 2020. ​

Literature Information ​

DOI10.3322/caac.21601
PMID32133645
JournalCA: a cancer journal for clinicians
Impact Factor232.4
JCR QuartileQ1
Publication Year2020
Times Cited2529
Keywordscolon and rectum neoplasms, epidemiology, health disparities, screening and early detection
Literature TypeJournal Article, Multicenter Study
ISSN0007-9235
Pages145-164
Issue70(3)
AuthorsRebecca L Siegel, Kimberly D Miller, Ann Goding Sauer, Stacey A Fedewa, Lynn F Butterly, Joseph C Anderson, Andrea Cercek, Robert A Smith, Ahmedin Jemal

TL;DR ​

Colorectal cancer (CRC) remains a significant health concern in the U.S., with an estimated 147,950 diagnoses and 53,200 deaths in 2020, particularly affecting younger adults under 50, where incidence rates are rising. The study highlights the importance of expanding access to screening and treatment to mitigate CRC rates, especially among high-risk populations such as Alaska Natives, and emphasizes the need to understand the increasing incidence in younger demographics.

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colon and rectum neoplasms · epidemiology · health disparities · screening and early detection

Abstract ​

Colorectal cancer (CRC) is the second most common cause of cancer death in the United States. Every 3 years, the American Cancer Society provides an update of CRC occurrence based on incidence data (available through 2016) from population-based cancer registries and mortality data (through 2017) from the National Center for Health Statistics. In 2020, approximately 147,950 individuals will be diagnosed with CRC and 53,200 will die from the disease, including 17,930 cases and 3,640 deaths in individuals aged younger than 50 years. The incidence rate during 2012 through 2016 ranged from 30 (per 100,000 persons) in Asian/Pacific Islanders to 45.7 in blacks and 89 in Alaska Natives. Rapid declines in incidence among screening-aged individuals during the 2000s continued during 2011 through 2016 in those aged 65 years and older (by 3.3% annually) but reversed in those aged 50 to 64 years, among whom rates increased by 1% annually. Among individuals aged younger than 50 years, the incidence rate increased by approximately 2% annually for tumors in the proximal and distal colon, as well as the rectum, driven by trends in non-Hispanic whites. CRC death rates during 2008 through 2017 declined by 3% annually in individuals aged 65 years and older and by 0.6% annually in individuals aged 50 to 64 years while increasing by 1.3% annually in those aged younger than 50 years. Mortality declines among individuals aged 50 years and older were steepest among blacks, who also had the only decreasing trend among those aged younger than 50 years, and excluded American Indians/Alaska Natives, among whom rates remained stable. Progress against CRC can be accelerated by increasing access to guideline-recommended screening and high-quality treatment, particularly among Alaska Natives, and elucidating causes for rising incidence in young and middle-aged adults.

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Primary Questions Addressed ​

  1. What factors contribute to the rising incidence of colorectal cancer among individuals under 50 years of age?
  2. How do colorectal cancer incidence and mortality rates vary among different racial and ethnic groups?
  3. What specific screening guidelines are recommended to improve early detection of colorectal cancer in younger populations?
  4. What advancements in treatment options have been made for colorectal cancer patients, particularly for those diagnosed at a younger age?
  5. How can public health initiatives effectively address the disparities in colorectal cancer outcomes among various demographic groups?

Key Findings ​

1. Research Background and Objectives: Colorectal cancer (CRC) has emerged as the second leading cause of cancer-related deaths in the United States, necessitating continuous monitoring and reporting of its incidence and mortality statistics. The American Cancer Society conducts updates every three years using data from population-based cancer registries and national health statistics. The objective of the 2020 report is to provide a comprehensive overview of CRC incidence and mortality trends, particularly focusing on demographic variations and age-specific changes in CRC rates.

2. Key Methods and Findings: The report utilizes incidence data from 2012 to 2016 and mortality data through 2017. It estimates that in 2020, around 147,950 new cases of CRC will be diagnosed, resulting in approximately 53,200 deaths. Notably, of these, 17,930 diagnoses and 3,640 deaths will occur in individuals under 50 years of age. The findings indicate significant disparities in incidence rates, with Asian/Pacific Islanders showing the lowest at 30 per 100,000 persons, while blacks exhibit a higher incidence at 45.7, and Alaska Natives at an alarming 89 per 100,000. The analysis reveals a decline in incidence rates among those aged 65 and older (3.3% annually from 2011 to 2016), contrasting with a 1% annual increase among individuals aged 50 to 64 and a 2% increase for those under 50, particularly driven by trends in non-Hispanic whites. In terms of mortality, rates decreased for those aged 50 and older but increased by 1.3% annually in younger populations.

3. Core Conclusions: The report highlights a troubling upward trend in CRC incidence among younger adults, particularly affecting non-Hispanic whites, while older adults benefit from improved screening and treatment, resulting in declining mortality rates. The findings suggest that while screening efforts have yielded positive results for older populations, there is a critical need to address the rising incidence and mortality in younger cohorts.

4. Research Significance and Impact: This report underscores the importance of enhancing access to CRC screening and high-quality treatment, particularly for populations such as Alaska Natives who demonstrate unique challenges. Additionally, the rising incidence in younger adults calls for further investigation into underlying causes and risk factors. The insights gained from this report are vital for informing public health strategies, promoting early detection, and tailoring interventions to reduce CRC burden across diverse demographics. The overall goal is to accelerate progress against CRC and ultimately decrease both incidence and mortality rates through targeted efforts.

Literatures Citing This Work ​

  1. Ex Vivo Organoid Cultures Reveal the Importance of the Tumor Microenvironment for Maintenance of Colorectal Cancer Stem Cells. - Xingru Li;Pär Larsson;Ingrid Ljuslinder;Daniel Öhlund;Robin Myte;Anna Löfgren-Burström;Carl Zingmark;Agnes Ling;Sofia Edin;Richard Palmqvist - Cancers (2020)
  2. Development and Validation of a Clinical Risk Score for Intensive Care Resource Utilization After Colon Cancer Surgery: a Practical Guide to the Selection of Patients During COVID-19. - Richard Garfinkle;Maria Abou-Khalil;Ebram Salama;Daniel Marinescu;Allison Pang;Nancy Morin;Sebastian Demyttenaere;A Sender Liberman;Carol-Ann Vasilevsky;Marylise Boutros - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (2021)
  3. Integrating Academic and Community Practices in the Management of Colorectal Cancer: The City of Hope Model. - Misagh Karimi;Chongkai Wang;Bahareh Bahadini;George Hajjar;Marwan Fakih - Journal of clinical medicine (2020)
  4. Characterization of lncRNA-Perturbed TLR-Signaling Network Identifies Novel lncRNA Prognostic Biomarkers in Colorectal Cancer. - Yanjie Chu;Zhiqiang Liu;Jing Liu;Lei Yu;Dekai Zhang;Fenghua Pei - Frontiers in cell and developmental biology (2020)
  5. Diagnostic performance of various liquid biopsy methods in detecting colorectal cancer: A meta-analysis. - Yuzhou Zhu;Tinghan Yang;Qingbin Wu;Xuyang Yang;Jianqi Hao;Xiangbing Deng;Shuo Yang;Chaoyang Gu;Ziqiang Wang - Cancer medicine (2020)
  6. Good for Us All. - Rachel B Issaka - JAMA (2020)
  7. Recommendations on Management of Locally Advanced Rectal Cancer During the COVID-19 Pandemic: an Iranian Consensus. - Zahra Siavashpour;Farzad Taghizadeh-Hesary;Afshin Rakhsha - Journal of gastrointestinal cancer (2020)
  8. Frequency of the TP53 p.R337H mutation in a Brazilian cohort of pediatric patients with solid tumors. - José Antonio da Silva Feitosa;Pablo Ferreira das Chagas;Graziella Ribeiro de Sousa;Rosane Gomes de Paula Queiroz;Gustavo Alencastro Veiga Cruzeiro;Luiz Gonzaga Tone;Kleiton Silva Borges;Elvis Terci Valera - Molecular biology reports (2020)
  9. Screening and Surveillance Colonoscopy and COVID-19: Avoiding More Casualties. - Samir Gupta;David Lieberman - Gastroenterology (2020)
  10. Case report of surgical management of a locally invasive colostomy adenocarcinoma. - Lindsay Pearson;Daniel M Chopyk;Seth A Rosen - International journal of surgery case reports (2020)

... (2519 more literatures)

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