Colorectal cancer reduces incidence in older people

News coming out of the United States about the rising incidence of this type of cancer is not encouraging, as recent preliminary research shows that colon cancer has been steadily increasing among young Americans over the past two decades, with the most dramatic effects seen in preteen children. will increase, with colon cancer rates increasing by 500 percent among children ages 10 to 14 between 1999 and 2020.

The rate also increased by 333 percent among young people aged 15 to 19 and by 185 percent among young people aged 20 to 24. “Colorectal cancer is no longer considered a disease of the elderly population,” study principal investigator Islam Mohamed, an internist at the University of Missouri-Kansas City, said in a press release. research at Digestive Diseases Week.

In Spain, according to the AECC, the average age of presentation is 70 years, and the majority of patients (>70%) are over 50 years old at the time of diagnosis, but they indicate that the disease can also appear in younger people, highlighting that the incidence increases in this age group. age group of people under 50 years old.

“In recent years, there has been alarm in the scientific world due to the increase in the number of young patients, whom we call persons under 50 years of age, which was the previous limit at which the risk of cancer increased sharply,” points out Rafael Lopez, head of the Medical Oncology Service of the University Hospital Complex Santiago de Compostela, who also leads the Translational Medical Oncology Group at the Health Research Institute of Santiago de Compostela; He is also an Associate Professor at the Faculty of Medicine of the University of Santiago de Compostela. “This appears to be the case because there is evidence that it is increased in some tumors; In others this is unknown because recording takes time, it is not an immediate problem,” he emphasizes: “Also, in Spain we have a problem: there is no national registry.”

The US study highlights that 0.6 children aged 10 to 14 were diagnosed per 100,000 people in 2020, up from 0.1 per 100,000 in 1999. The number of diagnoses in teenagers aged 15 to 19 years increased from 0.3 to 1.3 per 100,000. In young people aged 20 to 24, the number of cases increased from 0.7 to 2 per 100,000.

The increase was also seen in the highest age groups: in 2020, rates increased by 71%, to 6.5 cases per 100,000, among 30-34 year olds and by 58%, to 11.7 per 100,000, among 35 and 39 year olds years. The 40 to 44 year old group saw a smaller percentage increase of 37%, but with the highest incidence rate, reaching 20 per 100,000 people in 2020.

The “alarm that exists in the scientific world” is, for the head of the oncology service at the University Hospital of Santiago de Compostela, “a way to see how we can anticipate this trend that seems to exist”: “I think this is the reason for international collaboration , because there are a lot of numbers to do; Although there is an increase at younger ages, to ensure consistency we need to add data from as many populations, countries and continents as possible, because it will be easier to find the keys to it all.” Collaboration in recording or data collection will therefore be key to confirming this trend and understanding what measures can be taken. The same goes for preventive measures. “It is true that screening needs to improve as the age of incidence declines,” he insists.

An international investigation estimates that in 2024 there will be approximately 1,270,800 deaths from various types of cancer in the European Union as a whole. In the specific case of colorectal cancer, the researchers estimate that the death rate in the EU will increase among people aged 25 to 49 years; an increase that in Spain will be 5.5% among men. The authors of the study, published in the journal Annals of Oncology, linked higher mortality to overweight, obesity and alcohol use in this age group.

And among the risk factors for this type of tumor is a family history of inflammatory bowel disease or colorectal cancer, while modifiable risk factors point to factors such as consumption of ultra-processed foods, carbonated drinks or overuse of antibiotics. Rafael Lopez particularly highlights “tobacco.” “Tobacco causes many types of cancer; worldwide we can say that 20-25% of tumors would disappear if there was no tobacco,” he emphasizes. “The initiatives of some countries to create tobacco-free generations are highly recommended, and I even envy that Spain or Galicia are not joining this trend,” he adds.

Alcohol or lack of exercise are also underlying factors, as are diet or solarium. “It’s true that many of these factors involve cultural changes, and I don’t want to be harsh on tobacco, but we’ve been saying for years how bad it is and we continue to do the same,” he laments.

In addition, there is another factor, economic, which indicates that “healthy eating is the most expensive”: “Fruit, fish, fresh or seasonal products are more expensive, while ultra-fast food, on the other hand, is cheaper.” .