Age and lower gastrointestinal cancer

In 2000, with respect to the UK, it was stated (1):

• 99% of lower gastrointestinal cancer occurs in patients over 40 years old
  
  
• 85% of lower gastrointestinal cancer occurs in patients over 60 years old

UK statistics from CRUK state (2):

• bowel cancer incidence is strongly related to age, with the highest incidence rates being in older people
• in the UK in 2016-2018, on average each year more than 4 in 10 new cases (43%) were in people aged 75 and over
• age-specific incidence rates rise steeply from around age 50-54
• highest rates are in in the 85 to 89 age group for females and males
• incidence rates are significantly lower in females than males in a number of (mainly older) age groups
  • gap is widest at age 65 to 69, when the age-specific incidence rate is 1.7 times lower in females than males

However a New England Journal of Medicine review notes (3):

• early-onset disease (at <50 years of age) accounts for 10% of colorectal cancer cases, and the incidence is increasing, particularly in high-income countries
  • patients often present with advanced disease in the left colon
  • one in six patients has deficient DNA mismatch repair
  • screening is now recommended to begin at 45 years of age

Reference:

• (1) Referral Guidelines for Suspected Cancer (April 2000). NHS Executive
• (2) Cancer Research UK - Bowel Cancer Statistics (Accessed 23/4/2022)
• (3) Sinicrope FA. Increasing Incidence of Early-Onset Colorectal Cancer. N Engl J Med 2022; 386:1547-1558 DOI: 10.1056/NEJMra2200869