Background and Aims: Prior data showed an increasing incidence of early-onset colorectal cancer (EO-CRC) in the US. However, there are limited comprehensive data on recent EO-CRC incidence and mortality per different age cohorts and tumor characteristics. We aimed to evaluate EO-CRC incidence and mortality in different populations.Methods: Age-adjusted EO-CRC incidence rates were calculated from the USCS database between 2001 and 2021. Age-adjusted EO-CRC mortality rates were calculated from the NCHS database between 2000 and 2022 and the SEER database between 2004 and 2021. The age groups were 20–44 years and 45–54 years. Tumors were categorized by anatomical location (right, transverse, left, and proximal) and stage at diagnosis (early and late). The annual and average annual percentage changes (AAPC) were estimated using joinpoint regression. Age-specific pairwise comparison was conducted.Results: A total of 474,601 patients were diagnosed with EO-CRC between 2001 and 2021. The EO-CRC incidence increased in patients aged 20–44 years faster than in those aged 45–54 years (AAPC = 1.51 vs. 0.73; AAPC difference = 0.78,p= 0.001). This was most notable in proximal colon tumors (AAPC difference = 0.88,p< 0.001). While the incidence of early-stage tumors decreased in recent years across all anatomical locations, late-stage tumors increased, mostly in the proximal colon (AAPC = 2.44). A total of 147,026 patients died from EO-CRC between 2000 and 2022. Mortality increased in patients aged 20–44 years faster than in patients aged 45–54 years, who had a stable trend (AAPC difference = 0.85,p< 0.001). The increase in mortality was noted in both early- and late-stage tumors.Conclusions: Our study provides epidemiologic evidence showing an alarming increase in EO-CRC incidence and mortality among patients aged 20–44 years compared to those aged 45–54 years, which is associated with delayed diagnosis, and mostly in proximal colon tumors. Expanding screening efforts to younger populations and addressing healthcare disparities are essential for improving early detection and outcomes for younger patients.
**背景与目的：** 既往数据显示，美国早发性结直肠癌（EO-CRC）的发病率呈上升趋势。然而，关于近期不同年龄组和肿瘤特征的EO-CRC发病率与死亡率，尚缺乏全面的数据。本研究旨在评估不同人群中的EO-CRC发病率和死亡率。 **方法：** 基于美国癌症统计（USCS）数据库2001年至2021年的数据计算年龄调整后的EO-CRC发病率。基于国家卫生统计中心（NCHS）数据库2000年至2022年以及监测、流行病学和最终结果（SEER）数据库2004年至2021年的数据计算年龄调整后的EO-CRC死亡率。年龄组划分为20-44岁和45-54岁。肿瘤按解剖部位（右半结肠、横结肠、左半结肠、近端结肠）和诊断分期（早期、晚期）进行分类。使用连接点回归模型估算年度百分比变化和平均年度百分比变化（AAPC）。进行了年龄特异性配对比较。 **结果：** 2001年至2021年间，共有474,601例患者被诊断为EO-CRC。20-44岁患者的EO-CRC发病率增长速度高于45-54岁患者（AAPC = 1.51 vs. 0.73；AAPC差值 = 0.78，p = 0.001）。这一趋势在近端结肠肿瘤中最为显著（AAPC差值 = 0.88，p < 0.001）。尽管近年来所有解剖部位的早期肿瘤发病率均有所下降，但晚期肿瘤发病率却在上升，尤其是在近端结肠（AAPC = 2.44）。2000年至2022年间，共有147,026例患者死于EO-CRC。20-44岁患者的死亡率增长速度高于死亡率趋势稳定的45-54岁患者（AAPC差值 = 0.85，p < 0.001）。早期和晚期肿瘤的死亡率均有所上升。 **结论：** 本研究提供的流行病学证据表明，与45-54岁患者相比，20-44岁患者的EO-CRC发病率和死亡率呈令人担忧的上升趋势，这与诊断延迟相关，且主要见于近端结肠肿瘤。将筛查工作扩展至更年轻的人群并解决医疗保健差异，对于改善年轻患者的早期发现和治疗结局至关重要。
肿瘤(癌症)患者之家