OBJECTIVE: The incidence of colorectal cancer (CRC) declines among subjects aged 50 years and above. An opposite trend appears among younger adults. In Europe, data on CRC incidence among younger adults are lacking. We therefore aimed to analyse European trends in CRC incidence and mortality in subjects younger than 50 years. DESIGN: Data on age-related CRC incidence and mortality between 1990 and 2016 were retrieved from national and regional cancer registries. Trends were analysed by Joinpoint regression and expressed as annual percent change. RESULTS: We retrieved data on 143.7 million people aged 20-49 years from 20 European countries. Of them, 187 918 (0.13%) were diagnosed with CRC. On average, CRC incidence increased with 7.9% per year among subjects aged 20-29 years from 2004 to 2016. The increase in the age group of 30-39 years was 4.9% per year from 2005 to 2016, the increase in the age group of 40-49 years was 1.6% per year from 2004 to 2016. This increase started earliest in subjects aged 20-29 years, and 10-20 years later in those aged 30-39 and 40-49 years. This is consistent with an age-cohort phenomenon. Although in most European countries the CRC incidence had risen, some heterogeneity was found between countries. CRC mortality did not significantly change among the youngest adults, but decreased with 1.1%per year between 1990 and 2016 and 2.4% per year between 1990 and 2009 among those aged 30-39 years and 40-49 years, respectively. CONCLUSION: CRC incidence rises among young adults in Europe. The cause for this trend needs to be elucidated. Clinicians should be aware of this trend. If the trend continues, screening guidelines may need to be reconsidered.

Cancer Prevention The Maria Sklodowska Curie Memorial Cancer Center and Institute of Oncology Warsaw Poland

Catalan Cancer Plan Catalan Institute of Oncology L'Hospitalet del Llobregat Barcelona Spain

Centre d'investigations Clinique INSERM 1432 CHU Dijon Bourgogne Dijon France

CINTESIS Porto Faculty of Medicine University of Porto Porto Portugal

Department of Health Management and Health Economics University of Oslo Oslo Norway

Epidemiology and Cancer Registry Institute of Oncology Ljubljana Slovenia

Faculty of Medicine Masaryk University Institute of Biostatistics and Analyses Brno Czech Republic

Gastroenterology and Hepatology Erasmus MC University Medical Center Rotterdam The Netherlands

Gastroenterology Department Hospital Clínic de Barcelona Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas Universitat de Barcelona Barcelona Spain

Gastroenterology Hepatology and Clinical Oncology Medical Centre for Postgraduate Education Warsaw Poland

Gastroenterology Portuguese Oncology Institute of Porto Porto Portugal

Institute of Clinical and Preventive Medicine and Faculty of Medicine University of Latvia Riga Latvia

Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic

Internal Medicine 1st Faculty of Medicine Charles University Military University Hospital Prague Czech Republic

North Region Cancer Registry Department of Epidemiology Portuguese Oncology Institute of Porto Porto Portugal

Public Health Erasmus MC University Medical Center Rotterdam The Netherlands

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Arnold M, Sierra MS, Laversanne M, et al. . Global patterns and trends in colorectal cancer incidence and mortality. Gut 2017;66:683–91. 10.1136/gutjnl-2015-310912 PubMed DOI

Doubeni CA, Corley DA, Quinn VP, et al. . Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: a large community-based study. Gut 2018;67:291–8. 10.1136/gutjnl-2016-312712 PubMed DOI PMC

Rosato V, Bosetti C, Levi F, et al. . Risk factors for young-onset colorectal cancer. Cancer Causes Control 2013;24:335–41. 10.1007/s10552-012-0119-3 PubMed DOI

Siegel RL, Fedewa SA, Anderson WF, et al. . Colorectal cancer incidence patterns in the United States, 1974-2013. J Natl Cancer Inst 2017:109. PubMed PMC

Fitzmaurice C, Dicker D, Pain A, et al. . The Global Burden of Cancer 2013. JAMA Oncol 2015;1:505–27. 10.1001/jamaoncol.2015.0735 PubMed DOI PMC

Connell LC, Mota JM, Braghiroli MI, et al. . The rising incidence of younger patients with colorectal cancer: Questions about screening, biology, and treatment. Curr Treat Options Oncol 2017;18:23 10.1007/s11864-017-0463-3 PubMed DOI

Peterse EFP, Meester RGS, Siegel RL, et al. . The impact of the rising colorectal cancer incidence in young adults on the optimal age to start screening: Microsimulation analysis i to inform the american cancer society colorectal cancer screening guideline. Cancer 2018;124:2964–73. 10.1002/cncr.31543 PubMed DOI PMC

Wolf AMD, Fontham ETH, Church TR, et al. . Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin 2018;68:250–81. 10.3322/caac.21457 PubMed DOI

Troeung L, Sodhi-Berry N, Martini A, 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 Public Health 2017;5 10.3389/fpubh.2017.00179 PubMed DOI PMC

Deng Y. Rectal Cancer in Asian vs. Western Countries: Why the Variation in Incidence? Curr Treat Options Oncol 2017;18:64 10.1007/s11864-017-0500-2 PubMed DOI

Patel P, De P. Trends in colorectal cancer incidence and related lifestyle risk factors in 15-49-year-olds in Canada, 1969-2010. Cancer Epidemiol 2016;42:90–100. 10.1016/j.canep.2016.03.009 PubMed DOI

Karahalios A, English DR, Simpson JA. Weight change and risk of colorectal cancer: a systematic review and meta-analysis. Am J Epidemiol 2015;181:832–45. 10.1093/aje/kwu357 PubMed DOI

Gregor MF, Hotamisligil GS. Inflammatory mechanisms in obesity. Annu Rev Immunol 2011;29:415–45. 10.1146/annurev-immunol-031210-101322 PubMed DOI

Wolin KY, Yan Y, Colditz GA, et al. . Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer 2009;100:611–6. 10.1038/sj.bjc.6604917 PubMed DOI PMC

Yuhara H, Steinmaus C, Cohen SE, et al. . Is diabetes mellitus an independent risk factor for colon cancer and rectal cancer? Am J Gastroenterol 2011;106:1911–21. 10.1038/ajg.2011.301 PubMed DOI PMC

Fedirko V, Tramacere I, Bagnardi V, et al. . Alcohol drinking and colorectal cancer risk: an overall and dose-response meta-analysis of published studies. Ann Oncol 2011;22:1958–72. 10.1093/annonc/mdq653 PubMed DOI

Botteri E, Iodice S, Bagnardi V, et al. . Smoking and colorectal cancer: a meta-analysis. JAMA 2008;300:2765–78. 10.1001/jama.2008.839 PubMed DOI

Wei EK, Giovannucci E, Wu K, et al. . Comparison of risk factors for colon and rectal cancer. Int J Cancer 2004;108:433–42. 10.1002/ijc.11540 PubMed DOI PMC

Larsson SC, Wolk A. Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr 2007;86:556–65. 10.1093/ajcn/86.3.556 PubMed DOI

Giovannucci E. Insulin and colon cancer. Cancer Causes Control 1995;6:164–79. 10.1007/BF00052777 PubMed DOI

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