Study Suggests the Need for Heightened Awareness Among Clinicians
(New Brunswick, NJ) - Colorectal and pancreatic adenocarcinoma incidence rates have risen the most among young adults over the past two decades suggesting the need for heightened awareness among clinicians for these diseases, according to an article published today in JAMA Network Open by Robert Wood Johnson University Hospital (RWJUH), an RWJBarnabas Health facility, and Rutgers Robert Wood Johnson Medical School (RWJMS) researchers.
In a national cohort study of 275,273 cases of pancreatic adenocarcinoma and 215,200 cases of colorectal adenocarcinoma over a 21-year period (2000-2021), researchers found that the highest annual percentage change (APC) increase for both cancers occurred in the youngest age group of 15-34. For pancreas adenocarcinoma, the APC for age group 15-34 was 4.35, compared to 1.54 for age group 35-54, and 1.74 for age group older than 55. For colorectal adenocarcinoma, the APC for age group 15-34 was 1.75, compared to 0.78 for age group 35-54, and -3.31 for age group older than 55.
The study involved an analysis of representative groups in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database of all 22 registries. The SEER program provides information on cancer statistics in an effort to reduce the cancer burden among the U.S. population.
Arvind Trindade, MD, Chief of Endoscopy at RWJUH and Director of Endoscopic Research at RWJMS, designed the study and served as the senior author of the article, while Arvind Bussetty, MD, an internal medicine resident at RWJMS, was lead author. Dr Trindade conceived the idea for this study as clinically, he noticed he was diagnosing pancreatic adenocarcinoma more frequently among younger patients.
“Clinicians should be aware of this trend in younger age groups, so their suspicion is higher when patients present with symptoms,” Dr. Trindade explains. “Pancreatic cancer has traditionally been viewed a disease seen in older patients. However, this trend suggests the need for higher vigilance among providers when a younger patient is experiencing abdominal pain with other concerning symptoms, that could indicate a more serious condition.”
Pancreatic cancer is the seventh leading cause of cancer deaths worldwide. It has a five-year survival rate of only 10 percent and has doubled in incidence over that past 25 years. Colorectal cancer is the third leading cause of cancer death worldwide. Rising colorectal cancer rates among younger age groups led the United States Preventative Services Task Force in 2021 to recommend lowering the screening age from 50 to 45 in average-risk, asymptomatic individuals.
Dr. Trindade says that although there is no universal screening test for pancreatic cancer yet, endoscopic ultrasound (EUS) is an effective screening test for high-risk individuals with high-risk genes, a family history of pancreatic cancer in first-degree relatives, or with pancreatic cysts.
“Every month our digestive health center detects early precancerous growths in the pancreas on EUS,” Dr. Trindade says. “This can be lifesaving if these lesions are detected early and removed surgically.”
Colonoscopy continues to be the gold standard for detecting early colorectal cancer or precancerous polyps.
Both screenings are offered through the RWJUH’s Center for Digestive Diseases. He adds that RWJUH also offers a high-risk pancreas screening program and a pancreas cyst program.
The study does not identify root causes for the annual percentage change increase in cases, but Dr. Trindade believes a few factors may play a role.
“Clinically, we are seeing younger patients diagnosed with pancreatic cancer and this study supports our observations,” Dr. Trindade notes. “It could be related to dietary changes, specifically the consumption of processed foods, stress, and environmental factors.”
He adds that younger patients with a family history of pancreatic cancer should consult a gastroenterologist.
“The takeaway from this research is that symptoms such as upper abdominal pain in younger age groups should not be dismissed as benign without a complete gastrointestinal workup,” Dr. Trindade says. “And of course, if a person has high-risk genetics, a family history of pancreatic cancer, or a history of pancreas cysts, they need to be medically evaluated. Finally, patients who are average risk should undergo guideline-recommended screening colonoscopy at age 45.”
About Robert Wood Johnson University Hospital
Robert Wood Johnson University Hospital (RWJUH) New Brunswick, an RWJBarnabas Health Facility, is a 628-bed academic medical center that is New Jersey’s largest academic medical center through its deep partnership with Rutgers Robert Wood Johnson Medical School. RWJUH is the flagship Cancer Hospital of Rutgers Cancer Institute of New Jersey and The Bristol-Myers Squibb Children’s Hospital at Robert Wood Johnson University Hospital, a nationally-ranked 2024-25 Best Children’s Hospital by U.S. News & World Report. Centers of Excellence include cardiovascular care from minimally invasive heart surgery to transplantation, cancer care, stroke care, neuroscience, orthopedics, bariatric surgery and women’s health. A Level 1 Trauma Center and the first designated Pediatric Trauma Center in the state, RWJUH’s New Brunswick campus serves as a national resource in its ground-breaking approaches to emergency preparedness. For more Information visit us online at www.rwjbh.org/newbrunswick.
About Rutgers Robert Wood Johnson Medical School
As one of the nation’s leading comprehensive medical schools, Robert Wood Johnson Medical School is dedicated to the pursuit of excellence in education, research, healthcare delivery, and the promotion of community health. Part of Rutgers, The State University of New Jersey, Robert Wood Johnson Medical School encompasses 20 basic science and clinical departments, and hosts centers and institutes including The Cardiovascular Institute, the Child Health Institute of New Jersey, and the Women’s Health Institute. The medical school has been recognized by U.S. News & World Report as among the top 100 medical schools in the nation and No. 1 in the state for research and primary care.
Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital, an RWJBarnabas Health facility and the medical school’s principal affiliate, comprise one of the nation’s premier academic medical centers. Clinical services are provided by more than 500 faculty physicians in 200+ specialties and subspecialties as part of Rutgers Health, the clinical arm of Rutgers University. To learn more about Rutgers Robert Wood Johnson Medical School, visit www.rwjms.rutgers.edu.
Contact: Peter Haigney
RWJUH Public Relations
(732) 937-8568