Decline in the incidence of colorectal cancer and the associated mortality in young Italian adults

Correspondence to Manuel Zorzi, Veneto Tumour Registry, Azienda Zero, Padova 35132, Italy; manuel.zorzi@azero.veneto.it We have read with interest the article by Vuik et al that reported the trends in early-onset colorectal cancer (eoCRC) in 20 European countries.1 On the basis of data from nine of 20 Italian regions covering the years 1996–2009, Italy was the only European country where the incidence of eoCRC has dropped. The mortality rate (a well-recognised factor to consider in designing secondary cancer prevention strategies5) was always low among eoCRC patients, and this epidemiological profile (consistently with other international reports6) would not support any benefit of extending secondary prevention strategies to individuals under 50. The (coming?) globalisation of the exposure to risk factors (poor diet and obesity, among others) potentially linked to colorectal carcinogenesis (in adolescents and young adults too) should nonetheless prompt us to stay alert and quickly pick up any unfavourable change in Italian current epidemiological trends.4 For now, the available evidence does not support extending CRC screening programme to people under 50 (in Italy, at least).