Colon cancer incidence and trends in the last two decades: A SEER based data analysis.
Authors: Obeidat Khaldun , Abu-Tineh Mohammad , Turk Ekrem , Litvin Rafaella , Vakil Jay , Olafimihan Ayobami Gbenga , Ibrahim Muhammad Bilal , Mohamed Ibrahim Mohamed Izham , Gupta Shweta 
Published: June 2023

e15663 Background: Colorectal cancer (CRC) is the third most commonly occurring cancer in both men and women in the United States and the second most common cause of cancer mortality. Tremendous efforts have been made in the last few decades to increase awareness about colon cancer and importance of screening and early detection. In this study we aimed to trend colon cancer cases over years (2000-2019) Using SEER database. Methods: Patients diagnosed with Colorectal cancer between 2000 and 2019 were extracted from the Surveillance, Epidemiology, and Final Results (SEER) database. Year of diagnosis, age, sex, race, stage, 1-Year survival were included in the analysis. Patients were divided into groups depending on year of diagnosis and data analysis was done using SPSS (v29) to check race and sex percentages, mean age in each group. Patients were divided into subgroups depending on age and analysis was done to check percentage of cases in each subgroup. Results: A total of 727,590 patients with colorectal cancer were identified in the study period. There were 51.8% males and 48.2% females. White comprised 79.6% of the cases while 2nd and 3rd largest groups were Black 11%, Asian 7.9%. Mean survival was significantly higher among females (61.56 vs. 60.48 months with P value of < 0.001). By race mean survival was highest among Asian or pacific Islander then white followed by black and American Indian/Alaska Native (63.65, 61.43, 56.53 and 56.18 months respectively with P value of < 0.001). Incidence trends over the years was also analysed and the highest incidence found to be in 2002 (37372, 5.1%) and the lowest in 2013 (35073, 4.8%). There was a steady increase of male cases (50.7 % in 2000 to 53.4% in 2019). White race cases have been decreasing (84.2% in 2000 to 77.5% in 2019) with increase in all other races over the years. The mean age of cases has been decreasing overtime almost by 1 year every 5 years (66.88 in 2000 to 62.9 in 2019) and further analysis showed that the incidence of cases among younger age groups is increasing as 0.1% of cases in 2000 were in age group 18-25 which increased 8-fold to 0.8% in 2019. At the same time, the incidence started to go down in age groups 70 and above. In 2000 the highest percentage of cases was in the age group 75-79 (18%), while in 2019 the highest percentage was in the age group of 65-69 (14.5%). During the study period 1-year survival was steadily increasing from 2000 (76.5%) till 2007 (78.8%) then it was almost stable at the same rate till 2017. Conclusions: Over two decades, the incidence of colon cancer has shown a rise in minorities, exposing racial disparities in diagnoses. In addition, the main age at diagnosis has been steadily decreasing overtime. While new guidelines decreasing the starting age of screening colonoscopies is a step in the right direction, the alarming rise in cases among very young adults18-25 year of age requires studies to identify high-risk individuals in this group that may benefit from early screening.