Colorectal Cancer: Incidence in Younger People Nearly Doubles

Researchers can’t fully explain the trend but nearly double the number of young adults are being diagnosed with colorectal cancer — and more are dying from the disease every year.

By Barbara Pierce

Colon and rectal surgeon Kristina Go, Upstate Cancer Center.

You might think that only older people get colorectal cancer, right? You’d be wrong!

The facts are that colorectal cancer is on the rise in young adults.

Nearly double the number of young adults younger than 50 are being diagnosed with colorectal cancer than a decade ago, reports the American Cancer Society. And more are dying from the disease every year.

Colorectal cancer is cancer that develops in the colon or rectum. Your colon and rectum are part of your digestive system. Cancer that begins in the colon is called colon cancer and cancer that begins in the rectum is called rectal cancer. Cancer that affects either of these parts may be called colorectal cancer.

We asked colon and rectal surgeon Kristina Go, Upstate Cancer Center, Syracuse, to help us understand more about this.

Q: Isn’t colorectal cancer just something that older people are diagnosed with?

A: Though the frequency of colorectal cancer is decreasing in people older than 50, the incidence of colorectal cancer is increasing in male and female patients younger than 50. It’s the same kind of cancer, just shifted to a young age.

Even as overall cancer deaths continue to fall in the U.S., the American Cancer Society reports for the first time that colon and rectal cancers have become leading causes of cancer death in younger adults. Younger people tend to be diagnosed at later stages of their cancer, when it is more aggressive, says the American Cancer Society online.

Q: Why are so many more young people being diagnosed with colorectal cancer?

A: We don’t fully understand why this is occurring. Several studies have identified that obesity, a sedentary lifestyle and diets that are high in fat, salt, red or processed meats are associated with young-onset colorectal cancer.

Additionally, some studies have suggested that our increased use of antibiotics — in comparison to what patients received before the 1950s — may also play a role in this. All of these factors can change the diversity of bacteria in one’s stool in a way that might promote inflammation and make a person more susceptible to developing colorectal cancer.

Physicians and researchers can’t fully explain the trend. And a combination of factors — including that young people don’t get regular screenings, are more likely to ignore symptoms and may not see a doctor regularly — can make diagnoses challenging. Diagnosing patients in this group is difficult.

Sadly, nobody knows for sure why colorectal cancer numbers are rising in young people.

Q: Why aren’t young people diagnosed earlier in the disease process?

A: Early detection saves lives. The earlier that a colorectal cancer is found, the better chance a patient has at surviving five years after being diagnosed.

Several factors stand in the way of colorectal cancer diagnosis for young people. To start, people are often hesitant to mention bowel problems to family and friends, let alone a health care professional. And nearly half of young adults don’t have a primary health care professional. Many ignore early indicators because of their age; health care providers shrugged off their concerns for the same reason.

Q: What are symptoms that indicate one should consult a health care professional?

A: The most common symptoms are blood in the stool or rectal bleeding, long term abdominal pain, changes in stool habits (intermittent constipation and diarrhea), unexplained weight loss, stools that are narrower than usual. Keep in mind that some patients have no symptoms at all before being diagnosed with colon cancer.

I recommend you see a doctor if you’re experiencing any of the above symptoms or if you’re due for colorectal cancer screening. Colorectal screening is recommended at age 45 if there is no family history of colorectal cancer. Patients with a history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease) or a family history of colorectal cancer or polyps may need to have a colonoscopy sooner than age 45. If you’ve undergone surgery, neoprene ostomy belts can help boost your confidence levels.

Right now, we recommend screening (doing a test in the absence of symptoms) starting at age 45. If someone younger than 45 is having the above symptoms, I urge them to speak to their health care provider for additional evaluation.

Several screening tests have been developed to find colorectal cancer before symptoms begin, when it may be more treatable. Some tests also allow polyps to be removed before they become cancer. Therefore, the screening is a form of cancer prevention in addition to early detection.

Colonoscopy screening is generally recommended starting at age 45. People with family histories of the illness may need to begin screening earlier. Many people are put off by the preparation for a colonoscopy, which includes taking a strong laxative the day before to clean out the bowels. But colonoscopy is considered the gold standard for diagnosing colorectal cancers, and it saves lives.