Why Are People Being Diagnosed with Colon Cancer At Younger Ages?

A report from the American Cancer Society (ACS) shows younger adults are being diagnosed with colon and rectal cancer at higher rates in the last 25 years. The shift is drawing the attention of cancer researchers and healthcare providers alike.

Jason Gutman, MD, is a gastroenterologist working at Rochester General Hospital and shares what the report means for young patients and what people can do to protect against colorectal cancer.

Colorectal cancer patients are getting younger

Colorectal cancer is now the leading cause of cancer-related death in men under the age of 50 and the second highest cancer-related death for women under the age of 50. The disease is difficult to diagnose because symptoms are often mild or absent.

Many colorectal cancers start small as polyps – small growths that form on the lining of the colon or rectum. Most polyps cause no symptoms and may grow slowly over time before they become cancerous.

The percentage of colorectal cancer patients between the ages of 20-49 nearly doubled – going from 11 percent to 20 percent, according to research published by the American Cancer Society.

Researchers are still working to understand why rates are increasing in younger adults. Increasing rates of obesity especially in children and more sedentary lifestyle could be playing a role. Environmental and dietary factors could be among other reasons why experts are seeing more cases in younger patients.

More than half of all cases of colorectal cancer diagnoses are linked to lifestyle factors, including

• excessive alcohol drinking
• lack of physical activity
• smoking
• diets high in processed foods and red meats, and low in fiber

Family history plays a significant role in increasing the risk of developing colorectal cancer, according to the American Cancer Society. People whose parents, sibling, or child is diagnosed with colon or rectal cancer are as much as four times more likely to develop cancer themselves – especially if the person diagnosed is under the age of 50.

“During my 19-year career as a gastroenterologist, we have unfortunately seen more and more young patients presenting with colorectal cancer at a young age or finding colon cancer during their first screening exams,” Dr. Gutman said. “There is also intensive research looking into genetic factors and the gut microbiome, which have been changing over time that may increase your risk for colon cancer and other diseases.”

Preventing colon and rectal cancer

The American College of Gastroenterology and U.S. Preventive Services Task Force recommend regular colorectal screenings begin at age 45 for average risk adults (patients who do not have a history of cancer or are not at increased risk of colorectal cancer). However, patients with a family history or facing certain risk factors may need screening earlier and should talk with their healthcare provider about when that should happen.

Screening is the most effective way to reduce the risk of colorectal cancer. This is especially true for African American patients, who are about 20 percent more likely to be diagnosed with colorectal cancer and about 40 percent more likely to die after being diagnosed as compared to most other groups.

Paying attention to your health and getting in touch with your primary care provider if you start to experience sudden changes is very important. Examples of sudden changes include:

• sudden changes in bowel movements
• sudden abdominal pain/bloating
• blood in stool
• unintentional/unexplained weight loss

Depending on each person’s risk factors, there are different ways to screen for colorectal cancer. Some of these include:

• colonoscopy
• stool testing (FIT or Cologuard)
• CT colonography

“As a healthcare provider, one of our main goals in the care of our patients is prevention. An ounce of prevention is worth a pound of cure,” Dr. Gutman said. “As long as individuals are utilizing one of the screening processes we have available, we will be able to continue to decrease the rate of cancer death by either preventing future colon cancers or detecting it at an earlier stage.”