April 2 2020
The American Cancer Society has published updated colorectal cancer (CRC) incidence data (through 2016) from population based cancer registries and mortality data (through 2017) from the National Center for Health Statistics. Salient findings are as follows:
In 2020, 147,950 individuals are expected to be diagnosed with CRC and 53,200 will die from it. Among these, 12% of cases and 7% of deaths will be among individuals younger than 50.
Overall, the CRC patient population is shifting younger; the median age at diagnosis was 66 years in 2015–2016 compared with 72 years in 2001–2002.
Declines in CRC incidence in the 2000s continued in individuals aged ≥65 years; there was a 3.3% annual decrease in this group from 2011 to 2016.
In the 50–64 age group, annual incidence decreases of 2% to 3% during the 2000s have reversed, and rates increased by 1% annually between 2011 and 2016.
Incidence rates in individuals aged <50 years started to increase in the mid-1990s, initially driven by rectal cancer. Between 2012 and 2016, annual incidence rate increases of about 2% were observed for cancers of the proximal and distal colon as well as the rectum.
Between 2008 and 2017, mortality rates declined by 3% and 0.6% per year in individuals aged ≥65 and 50–64 years, respectively. However, in those aged <50 years, annual mortality increased by 1.3%.
Dr. Why: colorectal cancer owing to Human Papilloma Virus (HPV) was diagnosed in up to 51.8% of cases. Of these, the majority was linked to HPV 16 and 18, with tumor prevalence similar between genders.
Given the prevalence and mortality associated the CRC and cancers in general, why don’t we declare a pandemic? The hiatus of at least 6 weeks in performing elective procedures such as colonoscopy may delay diagnosis in as many as 17,071 patients or 2,845 per week!
THERE IS A NAME FOR THAT: A TUNNEL VISION. We run away from a lion king - “Coronavirus is undoubtedly our crowned King for a day” only to end up in a trap set by another invisible enemy.
The bad news: where is the express test for HPV? Nowhere to be seen!
The good news: there is an effective vaccine for HPV since 2006!
More bad news: 4 out of 5 Americans are infected with HPV in their lifetimes. The vaccine uptake amongst adolescents is 48%.