Trends and Projected Burden of Early-Onset Gastrointestinal Malignancies in the United States: A Population-Based Analysis (2001–2021)
Menée à partir de données 2001-2021 des registres américains des cancers portant sur 527 411 patients atteints d'un cancer gastro-intestinal de survenue précoce (âge : 20-49 ans), cette étude analyse l'évolution de l'incidence et présente des projections pour la période 2021-2031
Background: Early-onset colorectal cancer (eoCRC) has become a serious public health concern in recent years. This study aims to contribute to the growing body of evidence on the rise in early onset gastrointestinal cancers (eoGIC), anatomical sub-sites of eoCRC, and explore racial and gender disparities in these trends.
Methods: We analyzed data from the NPCR-SEER database (2001–2021) for people aged 20 to 49 with gastrointestinal (GI) cancers. The dataset covers cancer incidence rates for about 98% of United States population. Joinpoint regression was used to calculate average annual percent change (AAPC), and polynomial regression was applied to forecast rates from 2021 to 2031.
Results: A total of 527,411 cases were analyzed. Colorectal comprised of the highest cases (n = 313,513) followed by pancreatic (n = 50,448). Intrahepatic bile duct had the highest AAPC (+6.24%, 95% CI +5.20 to + 7.45) followed by small intestine (+3.19%, 95% CI: +2.69 to + 3.72), eoCRC (+1.65%, 95% CI: +1.45 to + 1.92), pancreatic (+1.52, 95% CI: +1.37 to + 1.66), and stomach (+1.20, 95% CI: +0.89 to + 1.53). In colorectum, rectum had the highest AAPC (+2.09%). Females (+1.81%) experienced disproportionate rise when compared to males (+0.83%). Projection suggests a demographic shift with female surpassing males in the overall age adjusted rate of eoGIC.
Conclusion: The study highlights that eoCRC is not an isolated phenomenon but part of a broader epidemiologic shift across gastrointestinal malignancies. The parallel rise in other sites suggests shared upstream risk factors or exposures and supports investigations into potential environmental, dietary, microbiome, or hormonal risk factors.
Journal of the National Cancer Institute , résumé, 2025