P0395 - Temporal Trends in Incidence Rates of Early-Onset Colorectal Cancer Across Racial Groups and Incident Diagnostic Stage: A SEER Database Analysis (2004-2020)

Karan Sachdeva, MD¹, Rohit Goyal, MD², Lovekirat Dhaliwal, MD³, Gabrielle Sanford, MD⁴, Shazia Rashid, MD¹, Aditya Vyas, MD⁴, Michael Tran, MD⁴, Maryam Mubashir, MD¹, Anjul Verma, MD⁵, Sudha Pandit, MD^1
1LSU Health, Shreveport, LA; ²Ochsner LSU Health, Shreveport, LA; ³Emory University School of Medicine, Atlanta, GA; ⁴Louisiana State University Health, Shreveport, LA; ⁵Texas Tech University Health Sciences Center, Odessa, TX

Introduction: Colorectal cancer (CRC) remains the second most fatal cancer in the USA, attributing to up to 9% of cancer-related deaths.Overall incidence of CRC has been improving as a result of the screening efforts, but the incidence of early-onset CRC (diagnosed before the age of 50 years) has been increasing. Racial disparities in the incident rate of early-onset CRC have been described in the past. We aim to evaluate the race-specific incidence time trend and annual percent change (APC) of the incidence rate stratified according to the stage at the diagnosis for early-onset CRC (EOCRC).

Methods: We utilized the Surveillance, Epidemiology, and End Results (SEER) 17 database to identify patients aged 20-49 years who were diagnosed with malignant cancer of the colon and rectum (excluding the appendix) with histology limited to adenocarcinoma from 2004 and 2020. The patient sample was stratified based on tumor stage at diagnosis (according to the combined summary stage 2004+, classifying CRC into: i. localized, ii. regional, and iii. distant), and annual age-adjusted incidence rates (IR) were obtained for the different race/ethnicities (White, Black, Asian/Pacific Islander [API], American Indian/Alaskan Native [AI/AN], and Hispanic). APC and average annual percent change (AAPC) were calculated.

Results: CRC incidence rates were highest in the Black population compared to other ethnicities in all the three staging groups. Figures 1A, 1B, and 1C demonstrate the time trend of incidence rates across different races in localized, regional and distant stages at the time of diagnosis. Although the Black population showed the highest average annual percentage increase in all the staging groups (AAPC 15.6 %, 18.6 %, 19.2 % for localized, regional and distant stages respectively), the results were not statistically significant (p value 0.89, 0.87, 0.97 for localized, regional and distant stages respectively).

Discussion: The incidence of advanced-stage cancer is trending up in all ethnicities, specifically higher in the Black population.The increased incidence of EOCRC is attributed to widespread availability of colonoscopy screening, birth cohort effect, and modifiable risk factor including access to health care, weight control, alcohol and tobacco use along with non-modifiable risk factor including gentic mutations, IBD. Increasing awareness about modifiable risk factors and addressing sociodemographic factors will help to improve cancer-related mortality.



Disclosures:


Karan Sachdeva, MD¹, Rohit Goyal, MD², Lovekirat Dhaliwal, MD³, Gabrielle Sanford, MD⁴, Shazia Rashid, MD¹, Aditya Vyas, MD⁴, Michael Tran, MD⁴, Maryam Mubashir, MD¹, Anjul Verma, MD⁵, Sudha Pandit, MD¹. P0395 - Temporal Trends in Incidence Rates of Early-Onset Colorectal Cancer Across Racial Groups and Incident Diagnostic Stage: A SEER Database Analysis (2004-2020), ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.