# Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years

Source: https://onco.cc/key-papers/paper-vuik-early-onset-colorectal-europe-gut-2019/  
OnCo record `paper-vuik-early-onset-colorectal-europe-gut-2019` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The same rise is happening in Europe. Across 20 countries and 143.7 million people, bowel cancer in 20 to 29-year-olds rose by 7.9 percent a year from 2004 to 2016.

## Summary

Vuik, Nieuwenburg, Bardou and colleagues retrieved age-related colorectal cancer incidence and mortality data for 1990 to 2016 from national and regional cancer registries in 20 European countries, covering 143.7 million people aged 20 to 49, of whom 187,918 (0.13 percent) were diagnosed with colorectal cancer. Trends were analysed by joinpoint regression and expressed as annual percent change.

The rise started earliest in the youngest group and appeared 10 to 20 years later in the older ones, which is the signature of a birth-cohort effect rather than of changed diagnostic practice. Incidence rose in most but not all European countries.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: colorectal-evidence
- Journal: Gut
- Year: 2019
- DOI: 10.1136/gutjnl-2018-317592
- Authors: Vuik FE, Nieuwenburg SA, Bardou M, et al.
- Findings: Incidence rose 7.9 percent per year in people aged 20 to 29 from 2004 to 2016.; 4.9 percent per year in those aged 30 to 39 from 2005 to 2016, and 1.6 percent per year in those aged 40 to 49 from 2004 to 2016.; The onset of the rise was 10 to 20 years later in each older age band, consistent with an age-cohort phenomenon.; Mortality did not change significantly in the youngest adults but fell 1.1 percent per year (ages 30 to 39) and 2.4 percent per year (ages 40 to 49).
- What it means: The European counterpart to Siegel 2017, and the evidence a UK screening age extension has to be argued against: the fastest relative rise is in people two decades below any screening programme's start age.
- Caveats: Registry data differ in completeness and coding between the 20 countries.; Very large annual percentage changes are computed on small absolute numbers in the youngest band.; Like every registry study it describes the trend without identifying its cause.

## Sources

- Gut 2019: https://doi.org/10.1136/gutjnl-2018-317592
- PubMed: https://pubmed.ncbi.nlm.nih.gov/31097539/
- Europe PMC full text (PMC6839794): https://europepmc.org/article/MED/31097539

## Connected records

- key papers: [Colorectal cancer incidence patterns in the United States, 1974-2013](https://onco.cc/key-papers/paper-siegel-colorectal-incidence-birth-cohort-jnci-2017/), [Geographic and age variations in mutational processes in colorectal cancer](https://onco.cc/key-papers/paper-diaz-gay-colibactin-geographic-age-mutational-processes-nature-2025/)
- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Early-onset colorectal cancer (under 50)](https://onco.cc/cancers/early-onset-colorectal/)
- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/), [Prevention & Risk](https://onco.cc/fronts/prevention/)
- technologies: [Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)](https://onco.cc/technologies/colorectal-screening/)
- bottlenecks: [Prevention we already have is not deployed](https://onco.cc/bottlenecks/b-prevention-adoption/), [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/)
- journals: [Gut](https://onco.cc/journals/gut/)
- roadmaps: [Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation](https://onco.cc/roadmaps/colorectal-roadmap/)
- ideas: [Find out what is driving early-onset bowel cancer, starting with colibactin, before extending screening any further](https://onco.cc/ideas/idea-crc-early-onset-cause-hunt/), [UK gap: shorten the route to diagnosis for patients below the screening age, where the rise in incidence is](https://onco.cc/ideas/idea-crc-uk-young-patient-referral-and-diagnostic-interval/)

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