- Mortality from the deadliest cancers has decreased among people younger than 50 over the last three decades in the U.S., with the exception of colorectal cancer.
- Colorectal cancer, which was the fifth leading cancer death in the early 1990s, is now the leading cancer death for males and females combined.
- Researchers emphasized the need for timely colorectal cancer screening, which is recommended to begin at age 45 for people at average risk.
Mortality from the deadliest cancers has decreased among people younger than 50 over the last three decades in the U.S., with the notable exception of colorectal cancer, according to data from the National Center for Health Statistics.
From 1990 through 2023, 1,267,520 people (53% female) died of cancer before they reached the age of 50, with the age-standardized death rate decreasing by 44% (25.5 to 14.2 per 100,000), reported Rebecca L. Siegel, MPH, of the American Cancer Society, and colleagues in a research letter in JAMA.
Among the five leading causes of cancer death, the mean annual decline from 2014 through 2023 was 0.3% for brain cancer, 1.4% for breast cancer, 2.3% for leukemia, and 5.7% for lung cancer.
On the other hand, colorectal cancer mortality increased by 1.1% annually since 2005 and was the leading cause of cancer death in females and males combined in 2023, up from the fifth most common from 1990 to 1994.
"Increasing mortality underscores the critical need for ongoing etiologic research to identify causes for increasing early-onset [colorectal cancer]," the authors wrote.
This increase in colorectal cancer mortality among younger adults is consistent with previously published reports, "and preempt[s] projections that [it] would lead cancer deaths in those younger than 50 years by 2040," Siegel and team noted.
Meanwhile, lung cancer and leukemia dropped in ranking from first to fourth and third to fifth, respectively, while breast cancer remained the second-leading cancer death overall and first in females.
Despite a continuous decline throughout the study period, cervical cancer remained the third leading cancer death among females in 2023, and pancreatic cancer became the fifth leading cancer death in males.
Co-author Ahmedin Jemal, DVM, PhD, also of the American Cancer Society, told MedPage Today that colorectal cancer is no longer a disease only associated with older age. "That's not the case anymore," he noted.
Several steps can be taken to reduce colorectal cancer mortality among younger adults, he said.
"Three out of four colorectal cancer cases in younger people are diagnosed at the advanced stage," Jemal explained. "We need to increase educational efforts among the general public and healthcare providers about the importance of recognizing the symptoms of colorectal cancer."
"We have to be cautious about having thorough examinations so that people with symptoms such as blood in the stool, or abdominal pain, can be diagnosed as early as possible," he added.
The authors noted that colorectal cancer screening before age 50 has been associated with both early diagnosis and reduced incidence and mortality. Screening is recommended to begin at age 45 for people at average risk and earlier for people with a genetic or family history that increases risk.
About half of colorectal cancer cases in people under the age of 50 occur in those ages 45 to 49, Jemal said. While up-to-date screening prevalence has increased in this age group, it was only 33.7% in 2023.
"We need ... to make sure those patients are up to date with colorectal cancer screening," Jemal pointed out.
A study limitation was the use of national-level ecologic data, Siegel and team noted, "but nevertheless [this study] identifies an urgent need for [colorectal cancer] prevention and early detection in younger adults."
Disclosures
The study was funded by the American Cancer Society.
The authors reported no relevant conflicts of interest.
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