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Young-onset colorectal cancer in the Asia–Pacific region

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Although evidence for increasing incidence has not yet been reported, we should be vigilant

When O’Connell and colleagues published their systematic review of young-onset colorectal cancer (CRC) in 2004,1 defined as CRC in a person no older than 40 years of age, there had only been one study in the Asia–Pacific region.2 Several reports have subsequently raised concerns about an increasing incidence of young-onset CRC in this region. If the number of patients is indeed rising, should we respond to this epidemiological problem with new measures?

Strong evidence suggests that the incidence of young-onset CRC is increasing in the United States and Europe, in contrast to a declining incidence in older people. Most of this evidence comes from population-based analyses of data from the SEER (Surveillance, Epidemiology and End Results) registries.3 In this issue of the MJA, investigators from New South Wales suggest that, at least at present, the incidence of young-onset CRC is not increasing here.4 Different trends in the incidence of young-onset CRC were reported by two earlier population-based studies in Australia.5,6 The most likely explanations for the disparity in the results of these studies…