Colorectal Cancer in Young African Americans: Is It Time to Revisit Guidelines and Prevention?
Previous studies have suggested an increase in the incidence of colorectal cancer (CRC) in young adults (younger than 50 years). Among older people, African Americans have disproportionally higher CRC incidence and mortality. We assessed whether this CRC disparity also applies to CRC diagnosed among young people.



Using the Surveillance, Epidemiology, and End Results cancer registries, a population-based cancer registry covering 25.6 % of the United States' African American population, we identified patients diagnosed with CRC between the years of 2000-2012. The age-adjusted rates for non-Hispanic whites (NHW), African Americans, and Asian-Pacific Islanders (API) were calculated for the age categories 20-24, 25-29, 30-34, 35-39, and 40-44.



CRC age-adjusted incidence is increasing among all three racial groups and was higher for African Americans compared to NHW and API across all years 2000-2012 (P < 0.001). Stage IV CRC was higher in African Americans compared with NHW, while there was higher stage III CRC in API compared with NHWs.



CRC incidence is increasing among the young in all racial groups under study. This increase in frequency of CRC is true among young African American adults who display highly advanced tumors in comparison with other races. While the present attention to screening seems to have decreased CRC prevalence in individuals older than 50, special attention needs to be addressed to young African American adults as well, to counter the observed trend, as they have the highest incidence of CRC among young population groups by race/ethnicity.
Department of Medicine, Cancer Research Center, Howard University College of Medicine, 2041 Georgia Avenue, N.W., Washington, DC, 20060, USA. hashktorab@howard.edu.|Department of Pathology, Howard University College of Medicine, Washington, DC, USA. hashktorab@howard.edu.
Hassan
H
Ashktorab
Department of Medicine, Cancer Research Center, Howard University College of Medicine, 2041 Georgia Avenue, N.W., Washington, DC, 20060, USA.|Department of Pathology, Howard University College of Medicine, Washington, DC, USA.
Kimberly
K
Vilmenay
Department of Medicine, Cancer Research Center, Howard University College of Medicine, 2041 Georgia Avenue, N.W., Washington, DC, 20060, USA.|Department of Pathology, Howard University College of Medicine, Washington, DC, USA.
Hassan
H
Brim
Department of Medicine, Cancer Research Center, Howard University College of Medicine, 2041 Georgia Avenue, N.W., Washington, DC, 20060, USA.|Department of Pathology, Howard University College of Medicine, Washington, DC, USA.
Adeyinka O
AO
Laiyemo
Department of Medicine, Cancer Research Center, Howard University College of Medicine, 2041 Georgia Avenue, N.W., Washington, DC, 20060, USA.|Department of Pathology, Howard University College of Medicine, Washington, DC, USA.
Angesom
A
Kibreab
Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Mehdi
M
Nouraie
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D001213:Asian / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000208:ethnology* / Q000473:pathology / Q000517:prevention & control; D055088:Early Detection of Cancer; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
Colorectal cancer; Race; SEER; Screening; Young adults