Colorectal Cancer in Young and Older Adults in Uruguay: Changes in Recent Incidence and Mortality Trends.

ABSTRACT

Uruguay has the highest colorectal cancer incidence rates in Latin America. Previous studies reported a stable incidence and a slight increase in mortality among males. We aimed to assess colorectal cancer incidence (2002-2017) and mortality trends (1990-2017) by age groups and sex, using data from the National Cancer Registry. Annual percent changes (APCs) were estimated using joinpoint regression models. We included 27,561 colorectal cancer cases and 25,403 deaths. We found an increasing incidence among both males and females aged 40-49, with annual increases of 3.1% (95%CI 1.21-5.03) and 2.1% (95%CI 0.49-3.66), respectively, and an increasein the rate in older males (70+) of 0.60% (95%CI 0.02-1.20) per year between 2002 and 2017. Mortality remained stable among those younger than 50, whereas it decreased for older females aged 50-69 and 70+ (APC -0.61% (-1.07-0.14) and -0.68% (-1.02-0.34), respectively), and increased for the oldest males (70+; APC 0.74 (0.47-1.01)). In conclusion, we found rising colorectal cancer incidence accompanied by stable mortality in young adults. Sex disparities were also found among the older adults, with a more favorable pattern for females. Exposures to dietary and lifestyle risk factors, and inequalities in access to and awareness of screening programs, are probably among the main underlying causes and deserve further investigation.