Colorectal Cancer
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European cancer mortality predictions for 2024 highlight a concerning increase in colorectal cancer deaths among people aged 29–45 years that the researchers suggest is linked to increasing rates of overweight and obesity.

For the 14th consecutive year, Carlo La Vecchia, professor of Medical Statistics and Epidemiology at the University of Milan in Italy, and colleagues have used data from the World Health Organization and Eurostat databases to predict death rates for all cancers and individually for stomach, colorectal, pancreatic, lung, breast, uterine (including cervical), ovarian, prostate, bladder cancers, and leukemias in the EU 27 Member States as a whole and separately in the U.K.

Overall, they found that the 2024 predictions for total cancer mortality rates in the EU remain favorable, with an estimated decline of 6.5% among men, from 131.8 per 100,000 in 2018 to 123.2 per 100,000 in 2024, and a fall of 4.3%, from 82.6 to 79.0 per 100,000 among women. In the U.K., the reduction is expected to be 13.8% in men, from 120.3 to 103.7 per 100,000, and by 9.9%, from 92.6 to 83.4 per 100,000, among women. In real terms, this equates to around 1.27 million cancer deaths in the EU around 172,000 in the UK.

However, increases in mortality are predicted for colorectal cancer among young adults in Italy, the U.K., Poland, and Spain for men, and Germany for women and in pancreatic cancer for both sexes across the EU.

The data are published in the Annals of Internal Oncology and this year have a special focus on colorectal cancer, which, among non-smokers, is the leading cause of cancer death in both sexes combined in the EU and UK.

Compared to 2018, overall death rates from colorectal cancer in the EU are predicted to fall by 4.8% to 14.7 men per 100,000 in 2024, and by 9.5% to 8.0 women per 100,000. In the UK, they are predicted to fall by 3.4% to 14.5 men per 100,000 but will remain stable in women at 10.2 per 100,000.

La Vecchia says: “These overall favorable trends can be explained by improved diagnosis and treatment of bowel cancer. Death rates tended to decrease in countries with better access to screening and early diagnosis. However, the increased mortality among young people is a concern.”

The authors predict that the greatest increase in bowel cancer death rates among younger people (25–49 years) will be seen in the U.K. where they will rise by 26.1% in men and by 38.6% in women in 2024 as compared with 2018. Increases will also be seen in Italy (up 1.5% in men and 2.6% in women), among Spanish and Polish men (up 5.5% and 5.9%, respectively) and German women (up 7.2%).

“Key factors that contribute to the rise in bowel cancer rates among young people include overweight, obesity and related health conditions, such as high blood sugar levels and diabetes,” says La Vecchia.

“Additional reasons are increases in heavier alcohol drinking over time in central and northern Europe and the U.K., and reductions in physical activity. Alcohol consumption has been linked to early onset bowel cancer, and countries where there has been a reduction in alcohol consumption, such as France and Italy, have not experienced such marked rises in death rates from this cancer. Early onset bowel cancer tends to be more aggressive, with lower survival rates, compared to bowel cancer that is diagnosed in older people.

“National governments should consider strengthening policies to encourage increased physical activity, a reduction in the number of people who are overweight or obese, and a reduction in alcohol consumption.”

La Vecchia also suggests that “governments should consider the extension of screening for bowel cancer to younger ages, starting at 45 years. Screening programs vary across Europe, but an increase in the incidence of bowel cancer among young people in the US has prompted the U.S. Preventive Service Task Force to recommend lowering the age at which screening starts to 45 years.”

But he points out that the cost/benefit estimates for this strategy are currently unquantified.

For pancreatic cancer, death rates are predicted to rise by 1.6% among EU men and 4.0% among EU women. Trends are better in the U.K. where they are expected to fall by 6.9% among men and 2.1% among women.

Professor Eva Negri, from the University of Bologna in Italy, who co-led the research notes: “Smoking is the main risk factor for pancreatic cancer, but it only partly explains the increased death rates over time. Overweight, obesity, diabetes, and heavy alcohol consumption may also play a role.”

The researchers calculated that, since 1988, about 6.2 million cancer deaths have been avoided in the EU and 1.3 million in the U.K. However, due to the increasing numbers of elderly people in the population, the actual number of deaths from cancer will not decline.

Although medium-term predictions are difficult, La Vecchia tells Inside Precision Medicine that “further declines in smoking prevalence and improved diagnosis and treatment suggest that further falls in cancer death rates are possible.”

He adds: “The control of overweight and obesity is a priority not only for vascular disease but also for cancer.”

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