ArticleJournal of the National Cancer Institute2025
Colon, colorectal, and all cancer incidence increase in the young due to appendix reclassification.
Article in Journal of the National Cancer Institute, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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19 citing papers in PubMed.
- Adolescents and young adults with cancers: comparative analyses of incidence and survival between Europe and the United States.ESMO real world data and digital oncology · 2026Article
- Bioinformatics analysis of proteins in the complement and coagulation cascades in colon cancer: Discovering the potential biomarker SERPINA1.Oncology letters · 2026Article
- Recent trends in Early-Onset cancer incidence rates.Journal of the National Cancer Institute · 2026Article
- Early and late-onset colorectal cancers: a case-case comparison of risk factors.Cancer causes & control : CCC · 2026Article
- Cancer trends in England in younger adults from 2001-2023: comparing incidence, mortality and stage at diagnosis.medRxiv : the preprint server for health sciences · 2026Article
- Increasing Burden of Early-Onset Cancers: Disentangling the Contributions of Changes in Risk from Demographic Shifts.Cancer research communications · 2026Article
- Multilevel insights into obesity, race/ethnicity, and survival in early-onset colorectal cancer in Georgia.Cancer causes & control : CCC · 2026Article
- Trends in Childhood and Adolescent Cancer Incidence Rates in the United States between 2001 and 2022.Cancer discovery · 2026Article
- Age-Specific Trends in Carcinoma Incidence Among Adolescents and Young Adults in the United States, 1975-2021.Cancer medicine · 2026Article
- Rising Incidence of Neuroendocrine Neoplasms in Northern Switzerland-Data From the Cancer Registry.Journal of the Endocrine Society · 2026Article
- Treatment Delays and Survival Divides: Race, Sex, and Early-Onset Colorectal Cancer Disparities.Cancer research communications · 2026Article
- Epidemiological Classification Changes and Incidence of Early-Onset Colorectal Cancer.JAMA network open · 2025Article
- Age-specific trends in colorectal, appendiceal, and anal tumour incidence by histological subtype in Australia from 1990 to 2020: a population-based time-series analysis.The Lancet regional health. Western Pacific · 2025Article
- Early-onset gastrointestinal cancers: comprehensive review and future directions.The British journal of surgery · 2025Review
- Age-specific trends in colorectal, appendiceal, and anal tumour incidence by histological subtype in Australia from 1990 to 2020: a population-based time-series analysis.medRxiv : the preprint server for health sciences · 2025Article
- Trends in Early-Onset and Late-Onset Colorectal Cancer by Subtype in New York State, 1976-2022.Journal of registry management · 2025Article
- Article
- Geographic and Demographic Disparities in Receipt of Treatment for Early-Onset Colorectal Cancer.Cancer control : journal of the Moffitt Cancer CenterArticle
- The Roles and Implications of m6A Methylation in Radiotherapy for Gastrointestinal Tumors.Dose-response : a publication of International Hormesis SocietyReview
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Abstract
backgroundIncreases in colon and colorectal cancer incidence among adolescents and young adults have been reported progressively. Most of the increase may be because of an artifact caused by reclassifying appendiceal carcinoids and neuroendocrine tumor (NET) as malignant.
methodsAge-adjusted incidence and survival data were obtained from the Surveillance, Epidemiology, and End Results SEER22 database.
resultsIn adolescents and young adults during 2000-2020, appendix cancer had an average annual percent change in incidence increase that in males was 3.7 times greater than the next most increasing cancer (average annual percent change = 12.8, 95% confidence interval CI] = 10.9% to 14.6% vs average annual percent change = 3.4 [kidney], 95% CI = 2.7% to 3.5%) and correspondingly in females 2.9-fold greater (average annual percent change = 14.6,95% CI = 11.9% to 17.3% vs average annual percent change = 4.2 [pancreas], 95% CI = 3.6% to 4.8%). From 2000-2009 to 2015-2020, appendix cancer incidence increased 17-, 6.5-, and 2.5-fold in children aged 0-14 years, adolescents and young adults aged 15-39 years, and adults aged 40-49 years, respectively. NET accounted for 95%, 90%, and 80% of appendix cancer increase in the 3 age groups, respectively. In 3446 adolescents and young adults diagnosed during 2010-2020 with malignant appendix NET, the 6-year cancer-specific survival was 99.4% (95% CI = 99.0% to 99.6%). From 2000-2009 to 2015-2020, colon carcinoma incidence in adolescents and young adults increased 61% with the appendix included and only 11% with the appendix excluded.
conclusionsReclassification of appendix NET/carcinoids as malignant has artifactually increased the incidence of colon, colorectum, and all cancer in children and adolescents and young adults. Appendix NET/carcinoids are rarely fatal in those aged younger than 40 years and should not be considered as cancer and included in colorectal cancer analyses. To the extent that the appendix artifact occurs in adults aged 40-49 years, recommendations for starting colorectal cancer screening earlier may be affected.
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