P0310 - The Evolving Landscape of Early-Onset Colorectal Cancer Mortality in the United States: A 25-year Analysis by Age, Sex, Race, and Region (1999-2023)

Udaya Kumar Damodaran, MD, Vidit Majmundar, MD, Priyal Dilip Mehta, MD, Utkarsh Dayal, MD, Edwin Saji, MD, Jason Jacobs, MD, Rohan Deo, MD
Saint Vincent Hospital, Worcester, MA

Introduction: Burden of Early-onset CRC [EOCRC] (diagnosed under 50 years) is rising globally and is expected to account for 11% of colon and 23% of rectal cancers by 2030. Given this growing incidence, we analyzed the mortality trends of EOCRC over 25 years in the US.

Methods: Mortality data for CRC in patients aged 15-49 years was extracted from CDC WONER database (1999-2023). Joinpoint regression analysis was performed and Annual percentage change by Age-group, sex, census region, and race was calculated. Data points with “unreliable” data were excluded from the analysis.

Results: Age specific analysis revealed that mortality decreased in 20-24y (APC=-1.90%) throughout and 25-29y after 2003 (APC=-0.95%, p< 0.05). But there was statistically significant increase in mortality among groups 30-34 (APC=1.07%), 35-39 (APC=1.32%), and 40-44 years (APC=1.01%). In 45-49 mortality improved until 2005, then significantly worsened. While mortality rate among females remained stable (APC=0.13%, p=0.20), pattern among males was complex with initial increase till 2001, a short decline (2001-2004), followed by significant rise (2004-2023, APC=0.85%, p< 0.05). Based on census regions, Northeast and South (highest mortality rate) showed relatively stable rates, while the Midwest demonstrated a modest increase (APC=0.58%). West showed relatively stable growth until 2017, followed by a sharp rise from 2017-2023 (2.72% APC, p=0.017). Among white population, mortality increased (APC=0.82%, p< 0.05). In Black/African American, mortality decline until 2019 followed by an uptrend (APC=2.00%). Asian/Pacific islander population showed an initial increase (9.78%, till 2002), followed by a decline (-7.84%, 2002-2005), then up-trended (APC=1.32%). American Indian/Alaska Native population had a gradual increase (APC=0.78%).

Discussion: The data revealed disproportionate mortality rates among certain populations. There is a significant rise in mortality among those aged 30-49 years throughout and males since 2004. There was a higher base-line mortality rate in South region throughout and an accelerating mortality rate in the Western region since 2017. Racial disparities existed with sustained increase among white population and recent rise in black population since 2019. These findings underscore the urgent need for specific screening strategies among vulnerable groups, targeted prevention strategies, and further research into the underlying factors of rising early-onset colorectal cancer mortality in specific populations.


Figure: Early-onset Colorectal cancer mortality rate from 1999-2023: Trend in various census regions in the US.


Figure: Early-onset Colorectal cancer mortality rate from 1999-2023: Trend among various age-groups in the US.

Disclosures:
Udaya Kumar Damodaran indicated no relevant financial relationships.
Vidit Majmundar indicated no relevant financial relationships.
Priyal Dilip Mehta indicated no relevant financial relationships.
Utkarsh Dayal indicated no relevant financial relationships.
Edwin Saji indicated no relevant financial relationships.
Jason Jacobs indicated no relevant financial relationships.
Rohan Deo indicated no relevant financial relationships.

Udaya Kumar Damodaran, MD, Vidit Majmundar, MD, Priyal Dilip Mehta, MD, Utkarsh Dayal, MD, Edwin Saji, MD, Jason Jacobs, MD, Rohan Deo, MD. P0310 - The Evolving Landscape of Early-Onset Colorectal Cancer Mortality in the United States: A 25-year Analysis by Age, Sex, Race, and Region (1999-2023), ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.