TRENDS OF COLORECTAL CANCER INCIDENCE RATES IN 40 – 49 YEAR OLD SUBJECTS: FIGURES FROM THE NORTH-EAST ITALIAN CANCER REGISTRIES

Aims:

The American Cancer Society recently lowered the age for starting colorectal cancer (CRC) screening from 50 to 45 years. The clinical rationale behind such a strategy lies in epidemiological evidence from the USA of a rising incidence of CRC before the age of 50.

In 2003, the European Council set the age to start CRC screening at 50 years, and all European screening programs (with Austria the only exception) still follow this recommendation.

In order to make available epidemiological data on the CRC risk among young Europeans, we analysed the trends of CRC incidence rates in 40 – 49 year olds of North-Eastern Italian Regions.

Methods:

We analysed the CRC incidence rates of the Cancer Registries of the North-Eastern Italian Regions (Bolzano, Friuli Venezia Giulia, Trento and Veneto; covered population = 7,200,000 subjects), from 2003 to 2014, separately for 40 – 44 and 45 – 49 year olds. We computed the Annual Percent Chance (APC), with 95% Confidence Intervals (95% CI).

Results:

No significant modifications have been registered in the malignant colorectal lesions incidence rates (years 2003 to 2014) among subjects younger than 50 years, the APC being 0.18 for 40 – 44 year olds (95% CI from -2.76 to 3.21) and APC -0.15 for 45 – 49 year olds (95% CI from -1.70 to 1.42).

Conclusions:

Our results should mean that we can rule out any need to change the CRC secondary prevention strategy with confidence. Making epidemiological data available on the temporal trends on the CRC risk among young European adults is an incoming priority.