“CRC remains a significant public health challenge in the United States, exerting a profound impact on individuals and health care systems alike,” Saqr Alsakarneh, MD, MSc, a second-year internal medicine resident at University of Missouri-Kansas City School of Medicine, told Healio. “Amidst the complexities of modern health care, understanding the nuanced trends in CRC incidence becomes paramount, guiding clinical practice and informing public health strategies.
“The endeavor to comprehend the dynamics of CRC incidence was born out of a recognition of its escalating burden across the nation.”
Using the CDC’s Wonder database, Alsakarneh and colleagues performed a race-, age- and sex-specific time-trend analysis of CRC incidence from 2000 through 2019. They estimated time trends as annual percent change (APC) and average APC (AAPC).
According to results presented at Digestive Disease Week, 2,927,574 (48.3% women) cases of CRC were reported from 2000 to 2019. The AAPC of all CRC cases dropped among women (–2.3%; 95% CI, –2.4 to –2.1) and men (–2.6%; 95% CI, –2.8 to –2.4), which corresponded with an absolute AAPC difference of 0.3% (95% CI, 0.1-0.6).
While CRC incidence increased among those aged younger than 45 years (AAPC = 2.4%; 95% CI, 2.2-2.7), researchers reported a reverse trend among those aged 45 years and older (AAPC = –2.7%; 95% CI, –2.9 to –2.5), with a between-group difference of 5.1% (95% CI, 0.1-0.6). In addition, CRC incidence rose among women aged younger than 45 years compared with their male counterparts (2.6; 95% CI, 2.2-2.9 vs. 2.3; 95% CI, 2-2.6).
“Delving deeper into this phenomenon, the analysis uncovered intriguing nuances based on gender, ethnicity and geographic region, painting a multifaceted portrait of CRC epidemiology in the U.S.,” Alsakarneh said. “One of the most striking findings was the disproportionate increase in CRC incidence among younger women compared to men — a trend that demands heightened attention and targeted interventions.”
The study also “illuminated regional disparities,” he added, noting the Northeast had the most pronounced decline (AAPC = –2.9%; 95% CI, –3.1 to –2.7) in CRC incidence rates compared with the South, which had the lowest (AAPC = –2.1%; 95% CI, –2.2 to –2).
By race, white individuals younger than 45 years had the highest increase in incidence (AAPC = 2.8%), while those aged 45 years and older had the greatest decrease (AAPC = –2.7%) across all racial and ethnic groups. Researchers also reported the lowest increase in incidence among younger Black individuals (AAPC = 0.9%) and lowest decrease among older American Indians (AAPC = –1.5%).
“These insights hold profound implications for patient care and public health policy,” Alsakarneh said. “By elucidating age-specific trends and the impact of screening interventions, clinicians are empowered to tailor preventive strategies and screening initiatives to high-risk populations.”
He continued: “The observed decline in CRC incidence among older individuals underscores the efficacy of screening efforts, underscoring the importance of continued investment in preventive health care measures.”
