Temple University Hospital Philadelphia, PA, United States
Neil Nadpara, MD, Gary Carbell, MD, Shalini Gingipally, MD, Frank Friedenberg, MD, MS (Epi) Temple University Hospital, Philadelphia, PA
Introduction: Colorectal cancer (CRC) is among the most commonly diagnosed cancers in the United States (US). Recognizing the increasing incidence of CRC in young adults, guidelines have recently changed to start screening for CRC at age 45. Our aims were to;1) examine trends in CRC from 1999-2018 and 2) identify factors associated with CRC below age 45 years in the US.
Methods: The CDC’s NHANES (National Health and Nutrition Examination Survey) is a nationally representative survey that combines interview and physical examination components to estimate the prevalence and risk factors of major diseases. We combined NHANES datasets from 1999-2018 and identified patients with a self-reported diagnosis of CRC. We divided patients by age of diagnosis: < 45 years vs >= 45 years old. Differences among these study groups were analyzed in SPSS v. 26 after appropriate sample weighting.
Results: There were 1,257,177 self-reported cases of CRC in the US from 1999-2018. 55.4% female, 44.6% male; race: non-Hispanic White (NHW) 80.7%, non-Hispanic Black (NHB) 9.5%, Hispanic/Asian 9.7%. Mean age at CRC diagnosis was 58.4 ± 15.3y; 15.9% had CRC diagnosed at age < 45y. The mean age (y) at diagnosis decreased over the study period as follows: 62.2 (95% CI 62.1-62.2) in 1999-2002; 62.8 (95% CI 62.7-62.9) in 2003-2006; 58.2 (95% CI 58.2-58.3) in 2007-2010; 56.9 (95% CI 56.9-57.0) in 2011-2014; 55.1 (95% CI 55.1-55.2) in 2015-2018 (p< 0.01). On univariate analysis NHB race was associated with CRC at age < 45y (18.9 % vs. 16.1% for NHW, p< 0.001). After adjusting for gender, education level, smoking status, and BMI, CRC at age < 45 remained associated with NHB race using NHW as the reference group (adjusted OR 1.09; 1.09-1.10).
Discussion: After weighting, there were 1.26 million self-reported cases of CRC in the US from 1999-2018; nearly one-sixth had a CRC diagnosed at age < 45 years. The mean age of CRC diagnosis significantly decreased over the roughly 2-decade study period. Our data justify the new CRC screening guidelines which recommend screening beginning at age 45. We further confirmed that these recommendations are particularly important for NHB patients.
Figure: Trend in Age of Colon Cancer Diagnosis
Disclosures: Neil Nadpara indicated no relevant financial relationships. Gary Carbell indicated no relevant financial relationships. Shalini Gingipally indicated no relevant financial relationships. Frank Friedenberg indicated no relevant financial relationships.
Neil Nadpara, MD, Gary Carbell, MD, Shalini Gingipally, MD, Frank Friedenberg, MD, MS (Epi). P1312 - Colon Cancer Prevalence: Trends From the National Health and Nutrition Examination Survey, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.
