Abstract

Abstract Background Colorectal cancer is the third most common malignancy and remains a leading cause of potentially preventable morbidity and mortality. Early-onset colorectal cancer (EOCRC) is a growing public health focus, particularly in North America, where incidence rates have increased over time. Aims Recognizing that EOCRC affects patients in the prime of their life, we aimed to estimate the impact of EO-CRC on disability-adjusted life years (DALYs) lost in Canada between 1990 and 2019. Methods We used the Global Burden of Diseases (GBD) Study to assess temporal trends in incidence, mortality and DALYs for EOCRC (patients ampersand:003C50 years old) in Canada between 1990 and 2019. Point estimates are available from http://ghdx.healthdata. org/gbd-results-tool. Rates were estimated per 100 0000 individuals at risk and stratified by age and sex. Annual percentage changes (APC) were estimated using joinpoint regression with 95% confidence intervals (CIs). Results In 2019, the incidence, mortality and corresponding DALYs rates for EOCRC were 15.67 (95% CI 11.58, 20.81), 3.19 (95% CI 2.81, 3.61), and 161.88 (95% CI 142.50, 183.53) per 100,000 individuals, respectively. Overall incidence increased significantly during the study period by 1.12%/year (95% CI 0.91%, 1.62%). An analysis of the temporal trends demonstrates that the most significant increase in incidence in EOCRC occurred between 2000 - 2006 with an APC of 3.19% (95% CI 2.40%, 3.99%), which was primarily driven by an increased incidence in men. Mortality (APC 3.30%, 95% CI 2.41%, 4.19%) and DALYs (APC 3.28%, 95% CI 2.34%, 4.22%) for EOCRC also significantly increased for males between 2001 - 2006. Conclusions Our study reveals a substantial burden in early-onset colorectal cancer in Canada, with a significant increase in incidence over time and over 160 DALYs/100,000 population. Figure 1: Incidence (A), Mortality (B) and DALYs (C) for EOCRC in Canada between 1990 and 2019 with 95% CIs. Funding Agencies None

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