Is the incidence of colorectal cancer increasing in the younger population? - a UK DGH experience

Shirish Tewari, Vinay Shah, Paul Cathcart, Vivek Gupta, Nick Reay-Jones


Background: Over the past few years we have noticed increasing number of young patients diagnosed with colorectal cancer being discussed in colorectal multidisciplinary team meetings. Our aim was to look if the incidence is in fact rising in the younger age-group patients, aged below 40 years.  

Methods: Retrospective data was collected from the Info flex database system at our DGH for all colorectal cancers diagnosed between January 2014-December 2019. The incidence of colorectal cancers under the age of 40 years was calculated as well as other demographics parameters were taken into consideration.

Results: Total 770 colorectal cancers were diagnosed during the study period. 451 (58.58% were male and 319 (41.42%) were female. The age range was 25-98 years. 2.06%, 3.19%, 1.14%, 0%, 2.22%, 2.38% patients below the age of 40 years were diagnosed with colorectal cancer in 2014, 2015, 2016, 2017, 2018 and 2019 respectively.

Conclusions: Our study does not show any increasing trend in the incidence of colorectal cancer in the younger population. One of the limitations of this study is the limited sample size used. A larger sample size or analysis of colorectal registries could be more informative to ascertain if there is a change in the age-distribution pattern of colorectal cancers.  


Colorectal cancer, Early-onset, Cancer, Incidence, Epidemiology

Full Text:



Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.

WHO Cancer Key Facts. Available at: Accessed on 29 September 2020.

UK CR Bowel Cancer Statistics: Cancer Research UK; 2020. Available at Accessed on 29 September 2020.

American Cancer Society. Colorectal Cancer Facts & Figures 2017–2019. Atlanta: American Cancer Society, 2017.

Colorectal Cancer Statistics. How common is Colorectal Cancer?. Available at: Accessed on 29 September 2020.

Brenner DR, Ruan Y, Shaw E, De P, Heitman SJ, Hilsden RJ. Increasing colorectal cancer incidence trends among younger adults in Canada. Prev Med. 2017;105:345-9.

Campos FGCM Figueiredo MN, Monteiro M Nahas SC, Cecconello I. Incidence of colorectal cancer in young patients. Rev Col Bras Cir. 2017;44:208-15.

Troeung L, Sodhi-Berry N, Martini A, Malacova E, Ee H, O’Leary P, et al. Increasing incidence of colorectal cancer in adolescents and young adults aged 15–39 years in Western Australia 1982–2007: Examination of colonoscopy history. Front Pub Heal. 2017;5:1-8.

Vuik FE, Nieuwenburg SA, Bardou M, Lansdorp-Vogelaar I, Dinis-Ribeiro M, Bento MJ, et al. Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years. Gut. 2019.

Araghi M, Soerjomataram I, Bardot A, Ferlay J, Cabasag CJ, Morrison DS, et al. Changes in colorectal cancer incidence in seven high-income countries: a population-based study. Lancet Gastroenterol Hepatol. 2019.

Exarchakou A, Donaldson LJ, Girardi F, Coleman MP. Colorectal cancer incidence among young adults in England: Trends by anatomical sub-site and deprivation. PLoS One. 2019;14(12):e0225547

Murphy G, Devesa SS, Cross AJ, Inskip PD, McGlynn KA, Cook MB. Sex disparities in colorectal cancer incidence by anatomic subsite, race and age. Int J Cancer. 2011;128:1668-75.

Cook MB, Dawsey SM, Freedman ND, Inskip PD, Wichner SM, Quraishi SM, et al. Sex disparities in cancer incidence by period and age. Cancer Epidemiol Biomark Prev. 2009;18:1174-82.

EC. The State of Men’s Health in Europe Report (Extended report). Luxembourg: European Commission; 2011.

CRUK/NCIN. Excess cancer burden in men. London: Cancer Research UK, NCIN, Leeds Met University, Men’s Health Forum; 2013.

Edgren G, Liang L, Adami H-O, Chang E. Enigmatic sex disparities in cancer incidence. Eur J Epidemiol. 2012;27:187-96.

Cook MB, McGlynn KA, Devesa SS, Freedman ND, Anderson WF. Sex disparities in cancer mortality and survival. Cancer Epidemiol Biomark Prev. 2011;20:1629-37.

Bates B, Cox L, Nicholson S, Page P, Prentice A, Steer T, et al. National Diet and Nutrition Survey: Results from Years 5 and 6 (combined) of the Rolling Programme (2012/2013–2013/2014). London: Public Health England; 2016.

Schütze M, Boeing H, Pischon T, Rehm J, Kehoe T, Gmel G, et al. Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. Bio Med J. 2011;342:d1584.

Chang LC, Wu MS, Tu CH, Lee YC, Shun CT, Chiu HM. Metabolic syndrome and smoking may justify earlier colorectal cancer screening in men. Gastrointest Endosc. 2014;79:961-9.

Tchernof A, Després J-P. Pathophysiology of human visceral obesity: an update. Physiol Rev. 2013;93:359-404.

Bassett JK, Severi G, English DR, Baglietto L, Krishnan K, Hopper JL, et al. Body size, weight change, and risk of colon cancer. Cancer Epidemiol Biomark Prev. 2010;19:2978-86.

Marino M, Masella R, Bulzomi P, Campesi I, Malorni W, Franconi F. Nutrition and human health from a sex-gender perspective. Mol Asp Med. 2011;32:1-70.

Moghaddam AA, Woodward M, Huxley R. Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomark Prev. 2007;16:2533-47.

Chacko L, Macaron C, Burke CA. Colorectal cancer screening and prevention in women. Dig Dis Sci. 2015;60:698-710.

Koo JH, Leong RWL. Sex differences in epidemiological, clinical and pathological characteristics of colorectal cancer. J Gastroenterol Hepatol. 2010;25:33-42.

Hansen IO, Jess P. Possible better long-term survival in left versus right-sided colon cancer - a systematic review. Dan Med J. 2012;59:A4444.

Lorentzen JA, Grzyb K, De Angelis PM, Hoff G, Eide TJ, Andresen PA. Oncogene mutations in colorectal polyps identified in the Norwegian colorectal cancer prevention (NORCCAP) screening study. Clin Med Insights Pathol. 2016;9:19-28.

National Cancer Intelligence Network (NCIN) and Cancer Research UK. Cancer Incidence and Survival by Major Ethnic Group, England, 2002-2006(link is external). London: NCIN; 2009.