The National Cancer Institute (NCI) has noted a rise in colorectal cancers among young adults. One out of every seven patients diagnosed with colon cancer (15%) are under the age of 50. Nearly 18,000 people under the age of 50 will be diagnosed with colorectal cancer this year in the United States The increased incidence of colon cancer in younger patients has been found worldwide, in the United States, Canada, Australia, Europe and Asia. According to the American Cancer Society, colon cancer will cause more than 49,000 deaths in the United States this year.
Colon cancer in patients under 50 appears to be more aggressive than in older adults. This is supported by additional research out of Yale Medicine that found patients under the age of 55 are 58% more likely to receive a diagnosis of an advanced form of colorectal cancer since the 1980s.
How are medical professionals addressing this growing issue?
The United States Preventive Services Task Force (USPSTF) had updated its colon cancer screening recommendations to start at age 45, instead of 50 years of age. Primary care physicians need to have the discussion with their patients starting ag 45. If there is a strong family history or co-existing inflammatory bowel disease (Crohn’s or Ulcerative Colitis), screening should start even earlier. The purpose of screening is to find the cancer before it causes symptoms. Indicators that could trigger a need for additional testing at any age include blood in the stool, rectal bleeding, and changes in bowel habits.
Colon cancer screening can be done in several ways, with varying degrees of inconvenience. Stool tests for blood and cancer proteins can be done annually, often with a mail-in test kit. Colonoscopy is a procedure in which a gastroenterologist uses a scope to go inside the colon and look for abnormal areas and early cancers. Patients should discuss the various options for screening to find what is right for them.
What lifestyle choices cause an increased risk in colorectal cancer?
The reason for the jump is not yet known, but medical specialists suspect the following play a role:
- Diet. A diet that has a large portion of high fat and processed meats while low in vegetables and fruit can contribute to a higher risk of this type of cancer.
- Lifestyle. A sedentary lifestyle can also play a role for multiple reasons, including the increased risk of obesity.
- Gut microbiome. The bacteria that live in our guts can play a role because some are known to aid in the growth and spread of colorectal cancer. A study out of Johns Hopkins University supports this theory finding that certain bacteria from the human gut increase the rate of intestinal cancer when placed in mice.
- Environmental factors. The National Toxicology Program led by the National Institute of Environmental Health Sciences identified eighteen chemicals that cause cancer in mice and rats. Some may do so by damaging DNA and causing mutations to the cells in the colon and rectum. Other chemicals can increase the risk of obesity or harm the gut microbiome. As such, it is also important to consider the impact of these chemicals on a person’s genetics.
- Alcohol and Smoking. As with other cancers, alcohol and cigarette smoking increase the risk of all cancers, including colon cancer.
Although the reasons for which colon cancer is being found with increasing frequency in patients under 50 are not completely known, the disease is being found in younger patients and often in a more aggressive form. Awareness and following colon cancer screening guidelines are the best ways to avoid advanced disease and death.