title: Young-onset colorectal cancer in New South Wales: a population-based study.
abstract: OBJECTIVE
  Australia has the highest incidence of colorectal cancer (CRC) in the world. The incidence of young-onset CRC (yCRC) is increasing in developed nations. Our aim was to determine the incidence of yCRC in New South Wales, the demographic and clinico-pathological characteristics of these patients, and their survival.
  
  
  METHODS
  A population-based cohort study of all cases of CRC diagnosed in NSW during 2001-2008. Data on newly diagnosed cases of CRC were obtained from the NSW Central Cancer Registry; mortality data were obtained from the NSW Registry of Births Deaths and Marriages (to 2012). The characteristics and tumour-related factors of patients under 50 years of age (yCRC) were compared with those for patients aged 50 years or more.
  
  
  METHODS
  Current incidence of yCRC and trends in incidence; 5-year cancer-specific survival rates and risks of death compared with older patients.
  
  
  RESULTS
  32 178 patients were diagnosed with CRC, including 2001 (6.2%) with yCRC. The incidence of yCRC was unchanged across the study period (2001, 13.7 cases per 100 000 population; 2008, 11.8 per 100 000; P = 0.26). Rectal cancer was more frequent in yCRC than in older patients (34.4% v 26.0%), as was distant disease (21.2% v 15.3%). However, 5-year cancer-specific survival was greater for patients with yCRC (68.8%; 95% CI, 66.2-71.2%) than for older patients (66.3%; 95% CI, 65.6-67.0%; P < 0.001).
  
  
  CONCLUSIONS
  The incidence of yCRC did not increase in NSW during 2001-2008. Despite more advanced disease at presentation, cancer-specific survival was better than for older patients with CRC.
authors.affiliation: Sydney Medical School, University of Sydney, Sydney, NSW m.a.gladman@sydney.edu.au.
authors.forename: Stephen
authors.initials: S
authors.lastname: Boyce
authors.affiliation: Menzies Centre for Health Policy, University of Sydney, Sydney, NSW.
authors.forename: Natasha
authors.initials: N
authors.lastname: Nassar
authors.affiliation: Sydney Medical School, University of Sydney, Sydney, NSW.
authors.forename: Cathy Yuen Yi
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Sydney Medical School, University of Sydney, Sydney, NSW.
authors.forename: Michael Kl
authors.initials: MK
authors.lastname: Suen
authors.affiliation: Sydney Medical School, University of Sydney, Sydney, NSW.
authors.forename: Saleh
authors.initials: S
authors.lastname: Al Zahrani
authors.affiliation: Sydney Medical School, University of Sydney, Sydney, NSW.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Gladman
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D009517:New South Wales / Q000453:epidemiology; D016016:Proportional Hazards Models; D012042:Registries; D015996:Survival Rate