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09 August 2017, 11:37 | Todd Saunders
Drop in death rates Among black individuals mortality declined throughout the study period
As reported previously by American Cancer Society investigators, colorectal cancer (CRC) incidence has been increasing in the United States among adults younger than 55 years since at least the mid-1990s. The rise was confined to white individuals according to the report, which appears in the Journal of the American Medical Association. Rates for African-Americans were found to be dropping in the same age group.
The study, spearheaded by lead researcher Rebecca Siegel of the American Cancer Society, analyzed the colorectal cancer mortality rates among USA adults between the ages of 20 and 54 from 1970 to 2014.
In recent years, reports have consistently shown colorectal cancer rates have been rising in Americans under the age of 55.
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Another striking finding was that the trend is being driven by increases in colorectal deaths among white men and women.
"The trend in colorectal cancer death rates in blacks is consistent with incidence trends, which are stable", Rebecca L. Siegel, MPH, director of surveillance information at the American Cancer Society, told HemOnc Today.
This increase relates only to the Whites: their mortality has climbed from 1.4% per year, reaching 4.1 per 100 000 in 2014 compared with 3.6 % a decade earlier, while that of Blacks has continued to decline by 0.4 % to 1.1 % per year from 1970 to 2014.
"We do not have an answer for why colorectal cancer is increasing in whites but not in blacks".
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Mortality rates declined among black individuals by 0.4% (95% CI, -0.6 to -0.3) annually to 1.1% (95% CI, -1.5 to -0.7) annually, from 8.1 per 100,000 in 1970 to 6.1 per 100,000 in 2014.
So what's going on?
"Delayed initiation of screening is likely behind these lower rates, as well as other barriers like insurance coverage, which is lower in ages 50 to 54 years than older adults because of the universal coverage offered by Medicare beginning at 65 years", Siegel said.
Researchers are looking into the matter, but many experts believe that the answer may lie partly in the microbiome, or the bacteria that normally live in the human body.
In the meantime, she emphasizes that while the overall risk of colorectal cancer in young and middle aged adults is still very small, there are preventive steps doctors and patients can take to protect themselves.
The important thing for now is to catch the cancer early on.
Know the symptoms. Persistent bleeding from the rectum or in the stool, cramping and change in bowel habits are the most common symptoms associated with colorectal cancer.
"It probably isn't cancer for people who are young or middle aged, but it could be", Siegal said, "so if we can get earlier detection in younger age groups then we can reduce the mortality and try to turn this trend around even before we know what's causing the increased incidence".
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