Age-related trends in the incidence of metastatic colorectal cancer from 2010 to 2019 in the USA

Figures & data

Figure 1. Patient disposition.

CRC: Colorectal cancer; mCRC: Metastatic colorectal cancer.

Table 1. Demographic and clinical characteristics.

Characteristics	Age 18–49 years (n = 1942)	Age 50–64 years (n = 5484)	Age ≥65 years (n = 16,544)	Total (n = 23,970)
Age, years   Mean (SD)   Median (IQR)	42.8 (5.7) 44.0 (40.0, 47.0)	57.7 (4.2) 58.0 (54.0, 61.0)	76.7 (7.2) 76.0 (71.0, 83.0)	69.6 (13.0) 71.0 (61.0, 80.0)
Sex, n (%)   Male	1087 (56.0)	3179 (58.0)	8008 (48.4)	12,274 (51.2)
Race, n (%)   White   Black   Hispanic   Asian   Missing	1256 (64.7) 209 (10.8) 244 (12.6) 92 (4.7) 141 (7.3)	3654 (66.6) 717 (13.1) 516 (9.4) 165 (3.0) 432 (7.9)	10,699 (64.7) 1980 (12.0) 1570 (9.5) 477 (2.9) 1818 (11.0)	15,609 (65.1) 2906 (12.1) 2330 (9.7) 734 (3.1) 2391 (10.0)
Region of the USA, n (%)   South   Midwest   West   Northeast   Other/missing	862 (44.4) 533 (27.4) 350 (18.0) 185 (9.5) 12 (0.6)	2603 (47.5) 1490 (27.2) 921 (16.8) 446 (8.1) 24 (0.4)	6226 (37.6) 3942 (23.8) 4033 (24.4) 2313 (14.0) 30 (0.2)	9691 (40.4) 5965 (24.9) 5304 (22.1) 2944 (12.3) 66 (0.3)
Insurance plan, n (%)   Medicare Advantage   Commercial   Missing	99 (5.1) 1843 (94.9) 0	1002 (18.3) 4482 (81.7) 0	15,140 (91.5) 1394 (8.4) 10 (<0.1)	16,241 (67.8) 7719 (32.2) 10 (<0.1)
CCI^†, n (%)   0   1   2   ≥3   Missing	1101 (56.7) 453 (23.3) 121 (6.2) 173 (8.9) 94 (4.8)	2364 (43.1) 1373 (25.0) 599 (10.9) 887 (16.2) 261 (4.8)	4442 (26.8) 3737 (22.6) 2530 (15.3) 5245 (31.7) 590 (3.6)	7907 (33.0) 5563 (23.2) 3250 (13.6) 6305 (26.3) 945 (3.9)
Hypertension, n (%)   Yes   Missing	376 (19.4) 94 (4.8)	2112 (38.5) 261 (4.8)	9651 (58.3) 590 (3.6)	12,139 (50.6) 945 (3.9)
Infectious disease, n (%)   Yes   Missing	^‡ 94 (4.8)	^‡ 261 (4.8)	15 (<0.1) 590 (3.6)	23 (<0.1) 945 (3.9)
Anemia, n (%)   Yes   Missing	367 (18.9) 94 (4.8)	1026 (18.7) 261 (4.8)	5165 (31.2) 590 (3.6)	6558 (27.4) 945 (3.9)
Gastric perforation, n (%)   Yes   Missing	11 (0.6) 94 (4.8)	38 (0.7) 261 (4.8)	102 (0.6) 590 (3.6)	151 (0.6) 945 (3.9)
Electrolyte disorder, n (%)   Yes   Missing	10 (0.5) 94 (4.8)	35 (0.6) 261 (4.8)	151 (0.9) 590 (3.6)	196 (0.8) 945 (3.9)
Existing wound, n (%)   Yes   Missing	9 (0.5) 94 (4.8)	54 (1.0) 261 (4.8)	231 (1.4) 590 (3.6)	294 (1.2) 945 (3.9)
Digestive system disease, n (%)   Yes   Missing	22 (1.1) 94 (4.8)	55 (1.0) 261 (4.8)	86 (0.5) 590 (3.6)	163 (0.7) 945 (3.9)
History of bleeding, n (%)   Yes   Missing	14 (0.7) 94 (4.8)	27 (0.5) 261 (4.8)	86 (0.5) 590 (3.6)	127 (0.5) 945 (3.9)

† Weighted CCI based on the following comorbid conditions: acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, dementia, chronic obstructive pulmonary disease, rheumatoid disease, peptic ulcer disease, mild and moderate/severe liver disease, diabetes mellitus with and without complications, hemiplegia/paraplegia, renal disease and acquired immune deficiency syndrome/human immunodeficiency virus.

‡ Values did not comply with the minimum cell size requirements outlined in the Centers for Medicare & Medicaid Services cell size suppression policy www.hhs.gov/guidance/document/cms-cell-suppression-policy.

CCI: Charlson Comorbidity Index; IQR: Interquartile range; SD: Standard deviation.

Table 2. Crude and standardized incidence rates of metastatic colorectal cancer by age group from 2010 to 2019.

Population	Rate	2010	2011	2012	2013	2014	2015	2016	2017	2018	2019
Overall	mCRC incidence	1808	1729	1912	2016	1950	2198	2690	2964	3292	3411
	Total enrollees	9,724,072	9,987,047	10,263,222	10,554,426	10,269,385	11,138,769	12,537,795	13,727,679	13,939,310	14,167,181
	Standardized IR^†	16.39	14.68	15.11	15.03	14.60	14.91	15.90	14.97	16.14	16.17
Age 18–49 years	mCRC incidence	188	155	169	178	193	173	206	201	239	240
	Total enrollees	5,174,013	5,205,360	5,170,123	5,186,856	4,969,417	5,338,764	5,776,781	6,061,687	5,966,534	5,842,005
	Standardized IR^†	3.31	2.75	3.08	3.25	3.76	3.18	3.47	3.24	3.92	4.04
Age 50–64 years	mCRC incidence	493	435	485	487	432	509	666	617	668	692
	Total enrollees	2,466,799	2,512,899	2,520,159	2,580,310	2,399,796	2,600,586	2,919,014	3,029,556	2,964,115	2,943,906
	Standardized IR^†	20.10	17.35	19.22	18.80	17.95	19.52	22.51	20.04	22.19	23.10
Age ≥65 years	mCRC incidence	1127	1139	1258	1351	1325	1516	1818	2146	2385	2479
	Total enrollees	2,083,260	2,268,788	2,572,940	2,787,260	2,900,172	3,199,419	3,842,000	4,636,436	5,008,661	5,381,270
	Standardized IR^†	64.42	57.55	61.58	57.26	50.89	54.76	53.49	51.96	54.79	50.50

† Standardized IR is reported per 100,000 US population.

IR: Incidence rate; mCRC: Metastatic colorectal cancer.

Figure 2. Standardized incidence rates (per 100,000) and annual percentage change for metastatic colorectal cancer by age group from 2010 to 2019.

APC: Annual percentage change.

Table 3. Crude and standardized incidence rates of metastatic colorectal cancer by sex from 2010 to 2019.

Sex	Rate	2010	2011	2012	2013	2014	2015	2016	2017	2018	2019
Female	mCRC incidence	913	865	923	960	934	1069	1296	1438	1607	1683
	Total enrollees	5,069,674	5,187,332	5,318,518	5,461,156	5,284,584	5,744,715	6,495,330	7,115,983	7,217,814	7,375,443
	Crude IR^†	18.01	16.68	17.35	17.58	17.67	18.61	19.95	20.21	22.26	22.82
	Standardized IR^†	16.09	14.23	14.11	13.80	13.36	13.80	14.44	13.92	14.76	14.75
Male	mCRC incidence	895	864	988	1056	1014	1128	1392	1524	1685	1728
	Total enrollees	4,652,907	4,798,313	4,943,168	5,091,865	4,983,567	5,392,890	6,041,410	6,610,591	6,720,597	6,790,957
	Crude IR^†	19.24	18.01	19.99	20.74	20.35	20.92	23.04	23.05	25.07	25.45
	Standardized IR^†	16.71	15.14	16.11	16.30	15.81	16.04	17.40	16.04	17.52	17.59

† Crude and standardized IRs are reported per 100,000 US population.

IR: Incidence rate; mCRC: Metastatic colorectal cancer.

Figure 3. Standardized incidence rates (per 100,000) for metastatic colorectal cancer by sex from 2010 to 2019.

Standard US population is based on the 2010 census. Patients with unknown sex were excluded from the denominator population.