Description and recent trends (2011-2019) of early-onset colorectal cancer incidence in Texas.
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BACKGROUND: Early-onset colorectal cancer (EO-CRC), diagnosed in individuals under 50, has seen rising incidence rates, while average-onset colorectal cancer rates decline. To understand EO-CRC burden across regions and patient characteristics, detailed incidence data are essential. With Texas's large population and unique demographics, this study examines recent trends in age-adjusted EO-CRC incidence. METHODS: This cross-sectional analysis used 2011-2019 Texas Cancer Registry (TCR) data. The incidence rate of EO-CRC was adjusted to the 2000 US standard population and was stratified by cancer type, sex, race/ethnicity, and stage at diagnosis. The number of EO-CRC cases between 2011 and 2019 was mapped to the Texas counties. RESULTS: In the study period, a total of 11,848 EO-CRC (7511 colon cancer [EO-CC] and 4337 rectal cancer [EO-RC]) cases were identified. Over 50 % of cases were diagnosed before the age of 45. The age-adjusted incidence rate (AAIR) of EO-CRC showed a slightly increasing trend over the study period (AAIR range: 10.4/100,000 persons [95 % CI = 9.8-11.0]- 12.7/100,000 persons [95 % CI = 12.0-13.3]). The AAIRs of EO-CRC among males were higher than that of females. Non-Hispanic (NH) White population had the highest AAIR, followed by the Black population and Hispanic population, while other races/ethnicities had the lowest AAIR of EO-CRC. The incidence rate of EO-CRC diagnosed at the regional stage was the highest and showed the steepest increasing trend. While EO-CRC case density by county reflects the population density, incidence rates were higher in rural counties. CONCLUSION: The incidence of EO-CRC in Texas showed an increasing trend from 2011 to 2019, with notable disparities by sex, race/ethnicity, and cancer stage.