National Trends in Early-Onset Colorectal Cancer: Incidence and Challenges in the Republic of Ireland

PURPOSE The incidence of early-onset colorectal cancer (EOCRC; CRC diagnosed before age 50 years) is increasing globally. This study analyses the trend in the Republic of Ireland over a 28-year period. METHODS Epidemiologic data on CRC incidence were obtained from the National Cancer Registry of Ireland (NCRI) from January 1994 until December 2021. Additional information on age of diagnosis and tumor sidedness for the entire period was obtained, while data relating to stage and sex were available for the study period 1999-2018. Incidence rates were stratified by sex, age group (20-34, 35-49, and ≥ 50 years), and tumor location. RESULTS Between 1994 and 2021, there were 61,180 cases of CRC among adults older than 20 years in the Republic of Ireland. The age-specific rate (ASPR) annual percentage change (APC) in patients younger than 50 years was 0.97 (95% CI, 0.30 to 1.76) in females and 0.57 (95% CI, 0.08 to 1.30) in males, while in patients age 50 years or older, it was –0.60 (95% CI, –1.03 to –0.15) in females and –0.70 in males (95% CI, –1.18 to –0.16), respectively. CONCLUSION In line with global trends, the incidence of EOCRC is increasing in Ireland. Further studies investigating the etiology and optimal treatment strategies for this cohort are necessary.