P1928 - Trends in the Incidence of Early-Onset Colorectal Cancer in Texas from 2000–2019

Adegboyega Olayode, MD, MPH¹, Omar Rosales, BS, MPH², Elyse Burgess, BS², Aaron Thrift, PhD², Hashem El-Serag, MD, MPH², Hemant Roy, MD², Abiodun Oluyomi, PhD^2
1Emory University School of Medicine, Atlanta, GA; ²Baylor College of Medicine, Houston, TX

Introduction: Although colorectal cancer (CRC) is prevalent among older people, studies over the past two decades show that its incidence among people under 50 years old (early onset CRC, EO-CRC) has been increasing. The reasons for this increase are not fully understood, though environmental factors rather than genetic ones are likely responsible. An assessment of EO-CRC over space and time may show locations of emerging or perpetual cancer burden and offer insights into possible drivers of EO-CRC.

Methods: Texas EO-CRC incidence rates were calculated using SEER*Stat (NCI); the SEER*Stat file includes denominator data for 19 five-year age groups and computes age-adjusted incidence rates as a weighted average of the rates for each 5-year age group. For our analyses, cases were restricted to those diagnosed ≤49 y.o. and assembled by the SEER*Stat age groups. The denominator data included the corresponding population for each 5-year age group up to ≤49 y.o. population. Incidence rates were age-adjusted to the 2000 U.S. Standard Population; hence our estimates are age-adjusted EO-CRC incidence per 100,000 persons. We calculated 2-year cumulative incidence rates for 10 separate periods (2000-2001, 2002-2003…2018-2019). First, we assessed temporal trends by county characteristic (metropolitan vs non-metropolitan) and county location (border vs non-border i.e. Texas-Mexico border). Second, we highlighted the distribution of EO-CRC incidence rates across Texas counties using choropleth maps. Last, we compared the geographic distributions and average mean incidence rates (paired sample T-test) between the first five periods (Episode 1) and last five periods (Episode 2).

Results: The time trend analysis shows increases in EO-CRC incidence rates in both metropolitan and non-metropolitan areas with the non-metropolitan slope being steeper. EO-CRC incidence rates were initially lower in non-metropolitan areas compared to metropolitan areas until 2012-2013 then subsequently became higher. Similarly, both border and non-border areas show temporal increases in the trend analysis with the slope being steeper for border areas. During Episode 2, the number of counties that had any EO-CRC incidence rates increased across the state, the EO-CRC incidence rates were significantly higher compared to Episode 1, 8.01/100,000 versus 6.30/100,000 (p < 0.001).

Discussion: In Texas, EO-CRC incidence rates increased from 2000 - 2019 statewide especially in the Texas-Mexican border areas.



Disclosures:


Adegboyega Olayode, MD, MPH¹, Omar Rosales, BS, MPH², Elyse Burgess, BS², Aaron Thrift, PhD², Hashem El-Serag, MD, MPH², Hemant Roy, MD², Abiodun Oluyomi, PhD². P1928 - Trends in the Incidence of Early-Onset Colorectal Cancer in Texas from 2000–2019, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.