Pancreatic cancer ranks as the seventh leading cause of cancer death globally. It has a 10% five-year survival rate and rising incidence, including in younger individuals, as of 2018 data. Colorectal cancer is the second leading cause of cancer death and shows an increasing incidence in younger populations. In 2021, this led to lowering the screening age from 50 to 45 for average-risk, asymptomatic people.
A recent study published in JAMA Network Open aimed to analyze the updated incidence trends of pancreatic and colorectal adenocarcinomas using a national cohort with a specific focus on annual percentage changes (APCs) among younger age groups.
In a retrospective cohort study, incidence rates for pancreatic and colorectal adenocarcinoma data were collected from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2021. The SEER database contained 22 population-based cancer registries covering 47.9% of the U.S. population. Patients diagnosed with pancreatic and colorectal adenocarcinoma were included in the analysis. Patients with other forms of pancreatic cancer, like solid pseudopapillary carcinoma, pancreatoblastoma, mucinous cystadenocarcinoma, neuroendocrine tumors, squamous cell, and serous cystadenocarcinoma, were excluded. Temporal trends in incidence rates of pancreatic and colorectal adenocarcinoma across covariates were assessed using annual percentage changes (APCs) and 95% confidence interval (CI) by the Joinpoint regression program version 5.3.0.
A total of 275,273 pancreatic adenocarcinoma cases (87.1% aged ≥55 years and male = 51.8%) were identified from 2000 to 2021. Joinpoint regression analysis showed an overall increasing incidence trend with no significant changes in slope. Out of the included patients, 0.4% were American Indian/Alaska Native, 5.4% were Asian or Pacific Islander, 91.8% were White, and 12.3% were Black.
A total of 1,215,200 patients with colorectal adenocarcinoma (80.4% aged ≥55 years and male = 52.8%) were identified between 2000 and 2021, showing an overall decreasing trend. By race, 6.2% were Asian or Pacific Islander, 81.1% were White, 12.2% were Black, and 0.5% were American Indian/Alaska Native.
The highest APC for pancreatic cancer was observed in patients aged 15-34 years (4.35; 95% CI, 2.03–6.73), significantly more compared to 35–54 (1.54; 95% CI, 1.18–1.90; P = 0.004) and ≥55 (1.74; 95% CI, 1.59–1.89; P = 0.007) groups. There was no significant difference between the 35–54 and ≥55 years with P = 0.98. The APC was higher in males (1.87; 95% CI, 1.63-2.11) compared to females (1.57; 95% CI, 1.27-1.87), though this was not significant with P = 0.13. All racial groups showed increasing trends in APCs.
The APC for colorectal cancer was found to be −3.31 (95% CI, −3.54 to −3.08) in those aged ≥55 years, significantly lower compared to those aged 15–34 (1.75; 95% CI, 1.08–2.42; P = 0.001) and 35–54 (0.78; 95% CI, 0.51–1.06; P = 0.002). Males had a slightly steeper decline (−2.70; 95% CI, −2.91 to −2.48) compared to females (−2.59; 95% CI, −2.84 to −2.34), but this was not significant with P = 0.52. APCs declined across all racial groups.
This study’s limitation includes partial population coverage, but focusing on common adenocarcinomas improves data accuracy and study group consistency.
In conclusion, this study reveals a concerning rise in pancreatic adenocarcinoma incidence across all age groups and a rise in colorectal adenocarcinoma incidence in the youngest populations. Greater awareness of these trends is essential when assessing younger patients with related symptoms.
Reference: Bussetty A, Shen J, Benias PC, Ma M, Stewart M, Trindade AJ. Incidence of Pancreas and Colorectal Adenocarcinoma in the U.S. JAMA Netw Open. 2025;8(4):e254682. doi:10.1001/jamanetworkopen.2025.4682
