Colorectal Cancer Death Rate Rising Among Young Whites

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Doctors need to urge patients to get timely follow-up for any concerning symptoms and consider early screening for some patients.

"This is not good news". The increase has been confined to white men and women and has been most rapid in metastatic disease. "Most of the time when we do a colonoscopy, they say 'that wasn't as bad as I thought it was, and I wish I would have done that earlier, '" said Dr. Steele.

They have also been surprised by the progression of the mortality by colorectal cancer in the over 50 years since its screening is recommended for decades from this age.

For the current study, ACS investigators led by Rebecca Siegel, MPH analyzed CRC mortality among persons aged 20 to 54 years by race from 1970 through 2014 using data from the National Center for Health Statistics. There were over 242,000 deaths due to this cancer in that time frame. The findings appeared in the most recent edition of Journal of the American Medical Association. Death rates are the gold standard for progress against cancer.

The increase was limited to whites, among whom mortality rates increased by 1.4 percent per year, from 3.6 in 2004 to 4.1 in 2014.

CRC mortality rates among those ages 20 to 54 declined from 6.3 per 100,000 in 1970 to 3.9 in 2004, at which point mortality rates began to increase by 1.0 percent annually, eventually reaching 4.3 per 100,000 in 2014.

Mortality rates declined among black individuals by 0.4% (95% CI, -0.6 to -0.3) annually to 1.1% (95% CI, -1.5 to -0.7) annually, from 8.1 per 100,000 in 1970 to 6.1 per 100,000 in 2014.

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Studies are needed to understand if other environmental factors affect colon cancer rates and survival differently for whites compared with blacks, he added.

The authors note that these disparate racial patterns are inconsistent with trends in major risk factors for colorectal cancer like obesity, which is universally increasing.

So what's going on?

"Delayed initiation of screening is likely behind these lower rates, as well as other barriers like insurance coverage, which is lower in ages 50 to 54 years than older adults because of the universal coverage offered by Medicare beginning at 65 years", Siegel said.

Researchers are looking into the matter, but many experts believe that the answer may lie partly in the microbiome, or the bacteria that normally live in the human body.

Cleveland Clinic medical oncologist Dr. Dale Shepard says, "I think it shows a risky trend that we've seen along the way".

Five years later. after surgery and chemotherapy, Katie is doing well, but new research finds a growing number of people in their 30s, 40s and early 50s not only diagnosed with colon cancer but dying from aggressive tumors.

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