Incidence Trends of Early-Onset Colorectal Cancer in Germany: A Registry-Based Study From 2003 to 2023

Motivated by studies on early-onset colorectal cancer (EO CRC, below 50 years) from the United States (US) and elsewhere, this study aimed to provide national incidence trends of EO CRC for Germany. For comparison, US cancer registry data was drawn from the Surveillance, Epidemiology, and End Results programs 21 population-based registries (SEER 21). From 2003 to 2023, ASRs of EO CRC increased for men (and women in Germany. By 10-year age groups, the increase was limited to men and women aged 20-29 years and 30-39 years. For appendix cancer, ASRs were rising for all age groups below 50 years of age. Increases for both colorectal cancer (excluding the appendix) and appendix cancer tended to be higher for cancers with good prognosis (neuroendocrine neoplasms, small size, low grading). In contrast to the US, Germany had a substantially lower EO CRC incidence in 2003 that increased at a slower pace. It is important to monitor future EO CRC incidence trends. The causes of the observed trends remain unclear.