Trends in colorectal cancer mortality among younger versus older adults in 49 countries.
Level 4 - case-series / case-control
Ecological time-trend analysis of national mortality registry databases
PubMed 42331356 · doi:10.1093/jnci/djag153
What was done
The authors analyzed colorectal cancer (CRC) mortality data from the World Health Organization Mortality database from 1990 to 2023 across 49 countries. They evaluated mortality trends over the most recent decade for younger adults (aged 25 to 49 years) and compared them with trends in older adults (aged 50 to 79 years).
What was found
Among younger adults (25 to 49 years), CRC mortality rates increased in 18 of 49 countries (0.7% to 4.3% per year), decreased in 15 countries, and remained stable in the remaining 16. Decreases greater than 2% per year occurred in Singapore, Belgium, and Denmark, while increases greater than 3% per year occurred in Paraguay, Uruguay, Chile, and the UK. In half of the 18 countries with rising rates in young adults, older adult rates were stable (Colombia, Philippines, Croatia [women only]) or decreasing (Uruguay, UK, Australia, Canada, US, Argentina). In the other half, primarily in Latin America and the Caribbean, mortality rates rose in both younger and older adults.
Why it matters
Colorectal cancer mortality is increasing among young adults in over a third of studied countries, often diverging from stable or improving trends in older populations. This highlights early-onset CRC as an emerging global burden requiring etiologic research and earlier detection.
Limits
The study is an ecological analysis of aggregate registry data; the abstract does not report overall participant or death counts, confidence intervals, or stage-specific data. It does not account for differences or changes in death certification quality, screening practices, or treatment access across countries.
Cited by
- supports Colorectal cancer complication and mortality rates are declining among older individuals.