Sex differences in the incidence trends of early-onset gastrointestinal cancer—the European/Mediterranean perspective

Background: While the rising incidence of early-onset colorectal cancer has been documented worldwide, there is a paucity of data on the epidemiological changes in other gastrointestinal (GI) cancers in the young population in Europe. We sought to characterize incidence patterns of GI cancers in young patients in different European/Mediterranean countries. Patients and methods: National cancer registries in several European countries were contacted to obtain the absolute number of GI cancer cases per age group (15-49 years) at 5-year intervals and the absolute population size for each of these age groups annually from 2008 to 2018. Data were analyzed to calculate year-to-year incidence rate change and average annual percentage change. Results: Seven countries were included in the analysis: the Czech Republic, Germany, Israel, the Netherlands, Norway, Slovenia, and Spain. Different trends were observed for different GI cancers. For colorectal cancer, all countries except Germany showed increasing incidence rates in a similar pattern for males and females. An increasing trend in pancreatic cancer was documented in the Czech Republic, more in males, and in Slovenia and Israel significantly more in females. There was a slight increase in Spain and Germany, with no difference by sex. The incidence of early-onset gastric and esophageal cancer was very low and non-rising. Conclusions: Early-onset cancers along the GI tract show different patterns in different European countries. For some types of GI tumors the incidence was fairly stable between 2008 and 2018 while some were increasing, in particular colorectal cancer in both sexes, and pancreatic cancer in females.