Yale University School of Medicine New Haven, CT, United States
Saif Zaman, MD1, Azubuogu Anudu, MD2, Saritza Mendoza, MD, MHS3, Camille Thelin, MD2 1Yale University School of Medicine, New Haven, CT; 2University of South Florida Morsani College of Medicine, Tampa, FL; 3University of South Florida, Tampa, FL
Introduction: The incidence of colorectal cancer in the United States has been declining by 2% per year, but regional differences remain. The purpose of this study is to assess the demographics, incidence, and risk factors of anal and rectosigmoid cancer in patients across the state of Florida.
Methods: Data were obtained from the Florida Cancer Data System (FCDS), the statewide cancer registry. Newly diagnosed cases of Anal (Anus, Anal Canal & Anorectum) (n = 9,408), Rectal (Rectum, Rectosigmoid Junction) (n = 75,582), and Colon (Cecum, Appendix, Ascending Colon, Hepatic Flexure, Transverse Colon, Splenic Flexure, Descending Colon, Sigmoid Colon) (n = 229, 345) malignancies from 1982 to 2016 were categorized according to age of diagnosis, year of diagnosis, sex, race, and cigarette use. Incidence and other statistics were calculated using original code written in python.
Results: Overall incidence was 1.76 (anal), 14.18 (rectal), 43.03 (colon) cases per 100,000 persons per year. A steady increase in anal malignancies, from 1.40 to 3.03 cases per 100,000 persons per year, was noted over the course of the study period. A decline, from 21.16 to 14.02 and 63.17 to 39.64 cases per 100,000 persons per year, was noted for rectal and colon malignancies, respectively. For anal malignancies the median age range at diagnosis was 60-64 years (2012-2016) and 65-69 years ( 1982-1986) (p < 0.0001). For rectal malignancies the median age range at diagnosis was 60-64 years ( 2012-2016) and 70-74 years (1982-1986) (p < 0.0001). For the cohort with anal malignancies the majority of patients were female (n = 5,899, 62.7%). For the cohort with rectal malignancies the majority of patients were male (n = 43,060, 57.0%). The majority of patients were Caucasian for both anal (n = 8,557, 91.2%) and rectal (n = 68579, 91.3%) cohorts. Cigarette use demonstrated an association with diagnosis, as 4,538 anal cancer patients (57.9%) and 28,535 rectal cancer patients (47.2%) had a positive smoking history.
Discussion: Overall, there is an increasing incidence of anal cancer between 1982-2016 in Florida. In contrast, there is a decreasing incidence of rectal and colon cancer in Florida. Both anal and rectal cancers have been more commonly diagnosed in younger populations in recent years which provides support for earlier screening practices for colorectal cancer. Physician awareness of changing incidences will enhance screening efforts.
Figure: Figure 1. Heatmaps representing age of diagnosis vs. year of diagnosis for anal, rectal and colon malignancies: red represents high frequency whereas blue represents low frequency.
Saif Zaman indicated no relevant financial relationships.
Azubuogu Anudu indicated no relevant financial relationships.
Saritza Mendoza indicated no relevant financial relationships.
Camille Thelin indicated no relevant financial relationships.
Saif Zaman, MD1, Azubuogu Anudu, MD2, Saritza Mendoza, MD, MHS3, Camille Thelin, MD2. P0255 - Increased Incidence of Anal, Rectal, and Rectosigmoid Cancer in Younger Populations in Florida From 1982-2016, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.