{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:13:34Z","timestamp":1788488014186,"version":"build-2803163510"},"reference-count":36,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","theclinics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Gastrointestinal Endoscopy Clinics of North America"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.giec.2026.02.002","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T20:51:26Z","timestamp":1778014286000},"page":"607-619","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Changing Epidemiology of Colorectal Cancer"],"prefix":"10.1016","volume":"36","author":[{"given":"Allison","family":"Janak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Cheong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.giec.2026.02.002_bib1","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1007\/s10620-014-3466-y","article-title":"The history of colorectal cancer screening: a personal perspective","volume":"60","author":"Winawer","year":"2015","journal-title":"Dig Dis Sci"},{"issue":"7","key":"10.1016\/j.giec.2026.02.002_bib2","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1056\/NEJM197302152880701","article-title":"Polypectomy via the fiberoptic colonoscope. Removal of neoplasms beyond reach of the sigmoidoscope","volume":"288","author":"Wolff","year":"1973","journal-title":"N Engl J Med"},{"issue":"19","key":"10.1016\/j.giec.2026.02.002_bib3","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1056\/NEJM199305133281901","article-title":"Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study","volume":"328","author":"Mandel","year":"1993","journal-title":"N Engl J Med"},{"issue":"9040","key":"10.1016\/j.giec.2026.02.002_bib4","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1016\/S0140-6736(96)03386-7","article-title":"Randomised controlled trial of faecal-occult-blood screening for colorectal cancer","volume":"348","author":"Hardcastle","year":"1996","journal-title":"Lancet"},{"issue":"1","key":"10.1016\/j.giec.2026.02.002_bib5","doi-asserted-by":"crossref","first-page":"47","DOI":"10.3109\/00365529209011166","article-title":"Causes of death during the first 5 years of a randomized trial of mass screening for colorectal cancer with fecal occult blood test","volume":"27","author":"Kronborg","year":"1992","journal-title":"Scand J Gastroenterol"},{"issue":"27","key":"10.1016\/j.giec.2026.02.002_bib6","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1056\/NEJM199312303292701","article-title":"Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup","volume":"329","author":"Winawer","year":"1993","journal-title":"N Engl J Med"},{"key":"10.1016\/j.giec.2026.02.002_bib7","unstructured":"Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov), SEER\u2217Stat Database: Incidence - SEER 8 Regs Research Data, Nov 2023 Sub (1975-2021), National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2024, based on the November 2023 submission."},{"key":"10.1016\/j.giec.2026.02.002_bib8","first-page":"162","article-title":"Trends in screening for colorectal cancer --- United States, 1997 and 1999","year":"2001","journal-title":"MMWR, Morbidity and Mortality Weekly Report"},{"issue":"1","key":"10.1016\/j.giec.2026.02.002_bib9","first-page":"10","article-title":"Cancer statistics, 2025","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J Clin"},{"issue":"9","key":"10.1016\/j.giec.2026.02.002_bib10","first-page":"761","article-title":"Are we doing enough to screen for colorectal cancer? Findings from the 1999 behavioral risk factor surveillance system","volume":"51","author":"Seeff","year":"2002","journal-title":"J Fam Pract"},{"key":"10.1016\/j.giec.2026.02.002_bib11","first-page":"881","article-title":"Vital signs: colorectal cancer screening test use-United states","volume":"62","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"10","key":"10.1016\/j.giec.2026.02.002_bib12","doi-asserted-by":"crossref","first-page":"2250","DOI":"10.1002\/cncr.32801","article-title":"Annual report to the nation on the status of cancer, part II: progress toward Healthy People 2020 objectives for 4 common cancers","volume":"126","author":"Henley","year":"2020","journal-title":"Cancer"},{"issue":"8","key":"10.1016\/j.giec.2026.02.002_bib13","doi-asserted-by":"crossref","first-page":"e235","DOI":"10.37765\/ajmc.2025.89779","article-title":"Racial\/ethnic differences in colorectal cancer screening in the US","volume":"31","author":"Wang","year":"2025","journal-title":"Am J Manag Care"},{"issue":"2","key":"10.1016\/j.giec.2026.02.002_bib14","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1053\/j.gastro.2019.10.029","article-title":"Causes of socioeconomic disparities in colorectal cancer and intervention framework and strategies","volume":"158","author":"Carethers","year":"2020","journal-title":"Gastroenterology"},{"key":"10.1016\/j.giec.2026.02.002_bib15","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/bs.acr.2021.02.007","article-title":"Racial and ethnic disparities in colorectal cancer incidence and mortality","volume":"151","author":"Carethers","year":"2021","journal-title":"Adv Cancer Res"},{"issue":"4_suppl","key":"10.1016\/j.giec.2026.02.002_bib16","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1200\/JCO.2025.43.4_suppl.91","article-title":"Impact of COVID-19 on colorectal cancer screening using Medicare Centers for Medicare and Medicaid Services (CMS) claims data","volume":"43","author":"Lim","year":"2025","journal-title":"J Clin Oncol"},{"issue":"699","key":"10.1016\/j.giec.2026.02.002_bib17","article-title":"Age-adjusted percentage of adults aged 50\u201375 years who received the recommended colorectal cancer screening, by sex and family income - national health interview survey, United States, 2021","volume":"72","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"10.1016\/j.giec.2026.02.002_bib18","series-title":"U.S. cancer statistics working group., U.S. cancer statistics data visualizations tool","year":"2025"},{"issue":"1","key":"10.1016\/j.giec.2026.02.002_bib19","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1158\/1055-9965.EPI-22-0544","article-title":"Impact and recovery from COVID-19-Related disruptions in colorectal cancer screening and care in the US: a scenario analysis","volume":"32","author":"van den Puttelaar","year":"2023","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"10.1016\/j.giec.2026.02.002_bib20","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2024.1468488","article-title":"Global, regional, and national trends in colorectal cancer burden from 1990 to 2021 and projections to 2040","volume":"14","author":"Zhang","year":"2024","journal-title":"Front Oncol"},{"issue":"1","key":"10.1016\/j.giec.2026.02.002_bib21","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1186\/s12885-025-15138-0","article-title":"Global burden of colorectal cancer in 2022 and projections to 2050: incidence and mortality estimates from GLOBOCAN","volume":"25","author":"Wu","year":"2025","journal-title":"BMC Cancer"},{"issue":"2","key":"10.1016\/j.giec.2026.02.002_bib22","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1053\/j.gastro.2019.07.055","article-title":"Epidemiology and mechanisms of the increasing incidence of Colon and rectal cancers in young adults","volume":"158","author":"Stoffel","year":"2020","journal-title":"Gastroenterology"},{"issue":"6","key":"10.1016\/j.giec.2026.02.002_bib23","doi-asserted-by":"crossref","first-page":"e1365","DOI":"10.1016\/j.cgh.2021.07.035","article-title":"Trends in early-onset vs late-onset colorectal cancer incidence by race\/ethnicity in the United States cancer statistics database","volume":"20","author":"Chang","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"3","key":"10.1016\/j.giec.2026.02.002_bib24","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.hoc.2022.02.005","article-title":"Colorectal cancer in younger adults","volume":"36","author":"Dharwadkar","year":"2022","journal-title":"Hematol Oncol Clin North Am"},{"key":"10.1016\/j.giec.2026.02.002_bib25","doi-asserted-by":"crossref","DOI":"10.1177\/10732748251363337","article-title":"Differential analysis of early-onset and late-onset colorectal cancer based on multidimensional evidence integration: a review","volume":"32","author":"Mi","year":"2025","journal-title":"Cancer Control"},{"issue":"4","key":"10.1016\/j.giec.2026.02.002_bib26","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1053\/j.gastro.2018.11.060","article-title":"Racial disparities in incidence of young-onset colorectal cancer and patient survival","volume":"156","author":"Murphy","year":"2019","journal-title":"Gastroenterology"},{"issue":"3","key":"10.1016\/j.giec.2026.02.002_bib27","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.cgh.2023.11.040","article-title":"Birth Cohort Colorectal Cancer (CRC): implications for research and practice","volume":"22","author":"Gupta","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"1","key":"10.1016\/j.giec.2026.02.002_bib28","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S1470-2045(24)00600-4","article-title":"Colorectal cancer incidence trends in younger versus older adults: an analysis of population-based cancer registry data","volume":"26","author":"Sung","year":"2025","journal-title":"Lancet Oncol"},{"issue":"6","key":"10.1016\/j.giec.2026.02.002_bib29","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1002\/cam4.3811","article-title":"Racial\/ethnic disparities in early-onset colorectal cancer: implications for a racial\/ethnic-specific screening strategy","volume":"10","author":"Acuna-Villaorduna","year":"2021","journal-title":"Cancer Med"},{"issue":"2","key":"10.1016\/j.giec.2026.02.002_bib30","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.cgh.2022.05.035","article-title":"Racial and ethnic disparities in early-onset colorectal cancer survival","volume":"21","author":"Zaki","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"11","key":"10.1016\/j.giec.2026.02.002_bib31","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1158\/1055-9965.EPI-14-0300","article-title":"A web tool for age-period-cohort analysis of cancer incidence and mortality rates","volume":"23","author":"Rosenberg","year":"2014","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"10.1016\/j.giec.2026.02.002_bib32","unstructured":"SEER\u2217Stat: SPD-wU. Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov (http:\/\/www.seer.cancer.gov\/%20\/t%20_blank)) SEER\u2217Stat Database: Incidence - SEER Research Data, 12 Registries, Nov 2022 Sub (1992\u20132020) - Linked To County Attributes - Time Dependent (1990\u20132021) Income\/Rurality, 1969\u20132021 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, released April 2023, based on the November 2022 submission."},{"key":"10.1016\/j.giec.2026.02.002_bib33","series-title":"Cancer facts & figures 2025","year":"2025"},{"issue":"7","key":"10.1016\/j.giec.2026.02.002_bib34","doi-asserted-by":"crossref","first-page":"e899","DOI":"10.1016\/S2214-109X(21)00143-1","article-title":"Global health in low-income and middle-income countries: a framework for action","volume":"9","author":"Olufadewa","year":"2021","journal-title":"Lancet Global Health"},{"issue":"10","key":"10.1016\/j.giec.2026.02.002_bib35","article-title":"Colorectal cancer screening and management in Low- and middle-income countries and high-income countries: a narrative review","volume":"16","author":"Abreu Lopez","year":"2024","journal-title":"Cureus"},{"key":"10.1016\/j.giec.2026.02.002_bib36","unstructured":"Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER\u2217Stat Database: Mortality - All COD, Aggregated With State, Total U.S. (1969-2022), National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2024. Underlying mortality data provided by NCHS (www.cdc.gov\/nchs)."}],"container-title":["Gastrointestinal Endoscopy Clinics of North America"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1052515726000255?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1052515726000255?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T01:44:16Z","timestamp":1788486256000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1052515726000255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["S1052515726000255"],"URL":"https:\/\/doi.org\/10.1016\/j.giec.2026.02.002","relation":{},"ISSN":["1052-5157"],"issn-type":[{"value":"1052-5157","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The Changing Epidemiology of Colorectal Cancer","name":"articletitle","label":"Article Title"},{"value":"Gastrointestinal Endoscopy Clinics of North America","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.giec.2026.02.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}