Birth Cohort Effects in Colorectal Cancer Impacting 50- to 54-Year-Olds

Birth Cohort Effects in Colorectal Cancer Impacting 50- to 54-Year-Olds

Douglas K. Rex, MD, MASGE, reviewing Zaki TA, et al. Gastroenterology 2021 Oct 28.

As birth cohorts younger than age 50 become progressively younger, the relative increase in colorectal cancer (CRC) risk compared to past decades becomes progressively greater. At the same time, older cohorts have experienced declining incidence rates of CRC. As the younger birth cohorts age, we are likely to see increasing incidence rates of CRC in older age groups as these cohorts carry their increased risk with them. 

Using Surveillance, Epidemiology, and End Results data, these authors discovered that overall U.S. CRC rates rose in parallel from 1992 to 2018 in 45- to 49-year-olds and 50- to 54-year-olds, while the incidence in 55- to 59-year-olds declined. This resulted in essentially equal incidence rates from 2016 to 2018 in 50- to 54-year-olds and 55- to 59-year-olds.

Douglas K. Rex, MD, FASGE


These data emphasize that we are likely to see these younger cohorts carry their higher risk of CRC with them as they age, necessitating intense encouragement for screening in persons age 45 or older. Eventually, we may see screening in patients younger than 45 years.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Zaki TA, Singal AG, May FP, Murphy CC. Increasing incidence rates of colorectal cancer at age 50-54 years. Gastroenterology 2021 Oct 28. (Epub ahead of print) (

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