Early-Onset Colorectal Cancer in Tennessee: Incidence Patterns, Survival Outcomes, and Mortality Risk Factors
Abstract
Background Early-onset colorectal cancer (EOCRC), defined as colorectal cancer diagnosed before age 50, is increasing in the United States. This study examined EOCRC incidence trends, survival, and predictors of mortality in Tennessee. Methods We analyzed data from 3,617 individuals aged 20–49 years diagnosed with colorectal cancer in Tennessee between 2011 and 2020. Kaplan–Meier methods were used to estimate 10-year overall survival and compare survival distributions. Cox proportional hazards regression identified predictors of mortality. Results Among 3,617 EOCRC cases, 1,109 (30.7%) died during follow-up. The overall incidence was 12.54 per 100,000 pop, ranging from 11.4 in 2013 to 13.5 in 2020 (APC = 1.37%). Ten-year overall survival was approximately 48% and differed significantly by sex (p = 0.0014), race (p < 0.0001), stage at diagnosis (p < 0.0001), and metastatic disease (p < 0.0001). In adjusted models, females had lower mortality compared with males (aHR = 0.79, p < 0.001). Compared with Black individuals, White individuals had reduced mortality risk (aHR = 0.82, p = 0.035). In situ (aHR = 0.08), localized (aHR = 0.10), and regional disease (aHR = 0.25) had lower hazards compared with distant-stage disease (all p < 0.001). Bone (aHR = 1.72), brain (aHR = 2.69), liver (aHR = 1.52), and lung metastases (aHR = 1.39) significantly increased mortality risk (all p < 0.001). Conclusion EOCRC incidence increased modestly in Tennessee between 2011 and 2020, with poor long-term survival. Mortality was associated with advanced stage, metastases, sex, and racial disparities, supporting the need for earlier detection and equity-focused interventions.
Start Time
15-4-2026 9:00 AM
End Time
15-4-2026 10:00 AM
Room Number
304
Presentation Type
Oral Presentation
Presentation Subtype
Grad/Comp Orals
Presentation Category
Health
Student Type
Graduate
Faculty Mentor
Bill Brooks
Early-Onset Colorectal Cancer in Tennessee: Incidence Patterns, Survival Outcomes, and Mortality Risk Factors
304
Background Early-onset colorectal cancer (EOCRC), defined as colorectal cancer diagnosed before age 50, is increasing in the United States. This study examined EOCRC incidence trends, survival, and predictors of mortality in Tennessee. Methods We analyzed data from 3,617 individuals aged 20–49 years diagnosed with colorectal cancer in Tennessee between 2011 and 2020. Kaplan–Meier methods were used to estimate 10-year overall survival and compare survival distributions. Cox proportional hazards regression identified predictors of mortality. Results Among 3,617 EOCRC cases, 1,109 (30.7%) died during follow-up. The overall incidence was 12.54 per 100,000 pop, ranging from 11.4 in 2013 to 13.5 in 2020 (APC = 1.37%). Ten-year overall survival was approximately 48% and differed significantly by sex (p = 0.0014), race (p < 0.0001), stage at diagnosis (p < 0.0001), and metastatic disease (p < 0.0001). In adjusted models, females had lower mortality compared with males (aHR = 0.79, p < 0.001). Compared with Black individuals, White individuals had reduced mortality risk (aHR = 0.82, p = 0.035). In situ (aHR = 0.08), localized (aHR = 0.10), and regional disease (aHR = 0.25) had lower hazards compared with distant-stage disease (all p < 0.001). Bone (aHR = 1.72), brain (aHR = 2.69), liver (aHR = 1.52), and lung metastases (aHR = 1.39) significantly increased mortality risk (all p < 0.001). Conclusion EOCRC incidence increased modestly in Tennessee between 2011 and 2020, with poor long-term survival. Mortality was associated with advanced stage, metastases, sex, and racial disparities, supporting the need for earlier detection and equity-focused interventions.
