The alarm has been sounding for a few years now: cases of colorectal cancer are increasing among younger people than previously recorded. Now research conducted by an international group of researchers, led by Carlo La Vecchia, professor of Medical Statistics and Epidemiology at the State University of Milan, adds an even more worrying piece: among young adults aged 25-49 the increase also concerns mortality, especially in the United Kingdom. The studyPublished on Annals of Oncologyreports the forecasts of mortality rates for all cancers in the European Union and the United Kingdom for 2024. The growth confirms a trend already noted and which could depend – say the scholars – on risk factors such as overweight, obesity and alcohol.
by Tina Simoniello
In 2024, the study predicts, the UK will see a 26% increase in colorectal cancer mortality in men and almost 39% in women compared to 2018. Increases are also estimated in some EU countries, including Italy.
by Simone Valesini
Alongside these data there is also good news: if you look at the entire population in general (and not just young people) the expected mortality from this type of tumor is, overall, decreasing throughout Europe. “These overall favorable trends can be explained by the improvement in diagnosis and treatment of colorectal cancer. Mortality rates tend to decrease in countries with better access to screening and early diagnosis programs. However, the increase in mortality among young people is worrying”, commented La Vecchia.
by Tina Simoniello
“Key factors contributing to rising colorectal cancer death rates among young people include overweight, obesity and related health conditions, such as high blood glucose levels or diabetes,” he continued the epidemiologist. The increase in alcohol consumption in central and northern Europe and the United Kingdom and the reduction in physical activity are further risk factors. Alcohol consumption, in particular, has been associated with colon cancer. rectum with early onset and, in fact, in countries where a reduction in alcohol consumption has been reported (for example France and Italy), there has not been a marked increase in mortality rates for this cancer. Compared to older people, the Colorectal cancer diagnosed in young adults also tends to be more aggressive and have lower survival rates.
Lower the screening age
According to La Vecchia, in light of this evidence “it would be important to consider the adoption of policies that promote the increase in physical activity, the reduction of the number of overweight or obese individuals and the limitation of alcohol consumption. Furthermore, in terms of early diagnosis, the extension of screening for colorectal cancer should also be evaluated, starting the campaign from the age of 45″. Screening programs vary in Europe, but the increasing incidence among young adults in the United States has already prompted the US Preventive Service Task Force to recommend reducing the age for starting screening to 45 years.
Mortality trends for all cancers
The researchers estimated a general decline in cancer mortality, more marked in the male population. However, due to the aging population, the absolute number of cancer deaths is expected to increase in the EU. The researchers also calculated the number of cancer deaths avoided in the period between 1989 and 2024, assuming that rates remained constant compared to 1988 levels. Well, thanks to early diagnosis and treatment, 6,183,000 deaths were avoided in EU and 1,325,000 in the UK.
by Elisa Manacorda
Lung cancer: no reduction in mortality in women
Although there is a favorable trend in men, lung cancer is characterized by the highest mortality rates for both sexes, both in the European Union and in the United Kingdom. For 2024, researchers estimate that in the EU they will decrease by 15% in men, while no reduction is expected in women. In the United Kingdom, however, there is a reduction in both sexes.
Breast cancer mortality trends continue to be favorable in the EU and UK. In 2024, a decrease of 6% in the EU and 11% in the UK is expected, from 15 to 13 per 100,000 women. “Advances in breast cancer diagnosis play a key role in the substantial decline in mortality rates , but advances in treatments and management of the disease are the main reasons for the increase in the number of people surviving,” he commented Eva Negriprofessor of Environmental Epidemiology and Occupational Medicine at the Department of Medical and Surgical Sciences of the University of Bologna and co-leader of the research.
Pancreatic cancer, very difficult both to detect and to treat successfully, is the only cancer for which a favorable trend in mortality is not expected in the European Union for both sexes. It represents a little more than 3% of new cancer diagnoses in Europe, but is the fourth leading cause of cancer death (7% of cancer deaths). Mortality rates in the EU are expected to increase by 1.6% in men and 4% in women. Trends are better in the United Kingdom, where a decline of 7% in men and 2% in women is estimated. “Smoking is the main risk factor for pancreatic cancer, but it only partially explains the increased mortality rates. Overweight, obesity, diabetes as well as excessive alcohol consumption can also play a role important”, added Eva Negri.
by Tina Simoniello
“These forecasts underline the importance of controlling and, ultimately, eliminating tobacco consumption – comments La Vecchia -. Tobacco remains responsible for 25% of all cancer deaths among men and 15% among women in the European Union. Not only is it the main risk factor for deaths from lung cancer, but also for other types of cancer, including pancreatic cancer. A further problem is represented by the increase in alcohol consumption in Europe central and northern”.
Bridging the gap between the countries of the Union
The forecasts also highlight the importance of closing gaps between European countries regarding cancer diagnosis and treatment programmes, the researchers finally write: mortality rates continue to be higher in Poland and other European countries central and eastern, and this is partly due to the inadequacy of screening programs to detect cancers such as breast, cervical and colorectal cancer, as well as the lack of access to the most modern therapies.