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Epidemiology and Mechanisms of the Increasing Incidence of Colon and Rectal Cancers in Young Adults

  • Elena M. Stoffel
    Affiliations
    Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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  • Caitlin C. Murphy
    Correspondence
    Correspondence Address correspondence to: Caitlin C. Murphy, PhD, MPH, Division of Epidemiology, Department of Population and Data Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390.
    Affiliations
    Division of Epidemiology, Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas

    Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
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      In contrast to the decreasing incidence of colorectal cancer (CRC) in older populations, the incidence has nearly doubled in younger adults since the early 1990s. Approximately 1 in 10 new diagnoses of CRC are now made in individuals 50 years or younger. Patients’ risk of CRC has been calculated largely by age and family history, yet 3 of 4 patients with early-onset CRC have no family history of the disease. Rapidly increasing incidence rates in younger people could result from generational differences in diet, environmental exposures, and lifestyle factors. We review epidemiologic trends in CRC, data on genetic and nongenetic risk factors, and new approaches for determining CRC risk. These may identify individuals likely to benefit from early screening and specialized surveillance.

      Keywords

      Abbreviations used in this paper:

      CRC (colorectal cancer), IBD (inflammatory bowel disease), MMR (mismatch repair)
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