Decline in the incidence of colorectal cancer and the associated mortality in young Italian adults

BACKGROUND Recent evidence has shown that although the incidence rate (IR) of colorectal cancer (CRC) is decreasing among older adults in several high-income countries, rates have increased in adults younger than 50 years. AIM To determine recent incidence trends of CRC in Italy up to 2014 by sex, age, and area. DESIGN, SETTING, AND PARTICIPANTS This study estimated the incidence of CRC using data from 48 Cancer Registry (2003-2014), including 60% of Italian population. MAIN OUTCOMES Annualized percentage changes and incidence rate ratios of CRC. RESULTS From 2003 to 2014, the incidence of CRC decreased both for men (Annual Percent Change -1.6, 95%CI -2.1 to -1.0) and for women (APC -1.2, 95%CI -1.8 to -0.6). Notably, men-female ratio is 1 below age 50 years while it is approximately 1.5 over 50 years of age. A significant decrease of incidence emerged in Northern Italy (from 11.1 per 100,000 in 2003 to 8.5 in 2014, APC -2.4), while stable rates were observed in Southern Italy (from 8.6 in 2003 to 8.8 in 2014; APC 0.05). CONCLUSIONS Leveling of CRC incidence in young adults among Italian areas strongly supports the need to reinforce research on specific risk factors and lifestyles possibly affecting these younger cohorts.