Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Global Burden of Early-Onset Bowel Cancer among Indigenous Peoples: A Systematic Review and Meta-Analysis (126286)

Tsegaw Amare Baykeda 1 , Shafkat Jahan 1 , Kirsten Howard 2 , Rakhee Raghunandan 2 , Mihye Jeon 1 , Gail Garvey 1
  1. School of Public Health, Faculty of Health, Medicine and Behavioural Science, The University of Queensland, Brisbane, Australia
  2. The Leeder Centre for Health Policy, Economics and Data, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia

Background: Early-onset bowel cancer (EOBC), defined as a bowel cancer diagnosis before age 50, is rising globally. However, its burden among Indigenous peoples remains unclear due to the lack of Indigenous data in global cancer statistics. This study aimed to systematically review the incidence, mortality, and survival of EOBC among Indigenous peoples.

Methods: A systematic search of PubMed/MEDLINE, Scopus, CINAHL, and Embase was conducted from inception to December 2024 using key terms such as “bowel cancer,” “incidence,” “mortality,” “survival,” and “Indigenous people,” with and without “early onset.” The review was synthesised according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A random-effects meta-analysis was employed to estimate the pooled proportion of EOBC among Indigenous and non-Indigenous peoples.

Results: Fifty-two studies were included, with 25 selected for the meta-analysis. The pooled proportion of EOBC incidence was 16% (95% CI: 14%–18%) for Indigenous peoples and 9% (95% CI: 8%–10%) for non-Indigenous peoples. Subgroup analyses consistently revealed higher proportions of EOBC incidence among Indigenous peoples across countries, time, and age groups. Most (76%) studies indicated higher age-standardised incidence rates among Indigenous populations, with 75% also reporting a greater annual percentage change in incidence for Indigenous peoples. All five studies that reported survival rates of EOBC showed poorer outcomes for Indigenous peoples compared to their non-Indigenous counterparts.

Conclusion: The pooled proportion of EOBC incidence among Indigenous peoples is nearly double that of non-Indigenous populations, with higher incidence rates, greater annual increases, and poorer survival compared to non-Indigenous peoples. The review highlights the need to design culturally relevant interventions to enhance bowel screening participation for eligible individuals, thereby ensuring timely detection and treatment and equitable access to health services for young Indigenous people globally. Further research is needed to understand the EOBC burden in countries such as Australia.