MedUni Vienna: Colorectal cancer affects an increasing number of younger men in Austria

In most European countries, including Austria, the incidence of colorectal cancer in the 55 plus generation has been falling steadily for 30 years. The reason for this is the implementation of screening colonoscopy. A large-scale study led by Monika Ferlitsch from MedUni Vienna's Department of Medicine III has now shown for the first time that there has been an increase in colorectal cancer in men in Austria over the same period, but not in women under 50. The research results have just been published in "JAMA Network Open".

The increase in colorectal cancer in men under 50 had until now been associated with constantly improving screening methods. "It was therefore assumed that colorectal cancer does not occur more frequently in younger people, but is simply diagnosed more often," reports Monika Ferlitsch from the Division of Gastroenterology and Hepatology at MedUni Vienna's Department of Medicine III. The large-scale study led by her is the first to provide evidence of the actual increase in bowel cancer and its precursors in men under 50. Women are not affected by this development. In fact, the incidence of bowel cancer and its precursors in men between 45 and 49 proved to be comparable to that of women ten years older.

11,103 data from younger people included

The study analysed the results of 296,170 screening colonoscopies performed within of quality certificate for screening colonoscopy in Austria in asymptomatic women (150,813) and men (145,357) between 2008 and 2018. The average age of the patients was 60, with 11,103 (i.e. 3.8 per cent) of the data coming from those under 50.

Particularly striking in the analysis was the increasing prevalence of certain colon polyps associated with a particularly high risk of cancer in younger men. Expressed in figures, the prevalence of these advanced adenomas (AAs) rose from 4.0 per cent in 2008 to 5.2 per cent in 2018 among younger patients. At the same time, this type of polyp was found in 7.3 per cent of over-50s in 2008 and only 6.8 per cent in 2018.

Screening recommended from 45

"The facts we have collected are not due to the increasing accuracy of diagnostics," says Ferlitsch. "These are clear figures that we need to look at in terms of prevention." Based on the evidence, the "National Screening Committee for Cancer" in Austria advises colon cancer screening by means of colonoscopy or blood stool testing from the age of 45 and not from the age of 50, as was previously the case. Monika Ferlitsch cites a lack of exercise, an unhealthy diet, obesity and diabetes in particular as possible causes for the increase in colorectal cancer in younger men.

Publication: JAMA Network Open

Colectoral Cancer and Precursor Lesion Prevalence in Adults Younger Than 50 Years Without Symptoms

Daniela Penz, Elisabeth Waldmann, Monika Hackl, Lena Jiricka, Lisa-Maria Rockenbauer, Irina Gessl, Jasmin Zessner-Spitzenberg, Arnulf Ferlitsch, Michael Trauner, Monika Ferlitsch

DOI: 10.1001/jamanetworkopen.2023.34757

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