Cancer care experts are highlighting a concerning trend that has emerged in recent years – a significant increase in colorectal cancer cases among younger adults. Colorectal cancer, traditionally seen as a disease of older individuals, has become the leading cause of cancer death among people under 50.
In 2023, the American Cancer Society (ACS) reported that 20% of diagnoses in 2019 were in patients under age 55 – about double the rate in 1995. In addition, rates of advanced disease increased by about 3% annually in people younger than 50.
Dr. Amir Bista, a physician specializing in hematology, oncology, and internal medicine with ThedaCare Cancer Care, has seen the trend taking place locally.
“I have had young patients who were diagnosed at the advanced stages of the disease,” he explained. “At times, people might have been unaware of their symptoms, which could have led to the later diagnosis.”
Dr. Bista also noted he has had patients who were diagnosed very early, when they followed through with recommended screenings early in life due to family history of colon cancer.
Learning from the Statistics
The ACS projects around 151,000 Americans will be diagnosed with colorectal cancer in 2024. The number of older adults diagnosed with colorectal cancer has been decreasing since the 1980s. However, cases in people younger than 55 have been increasing by 1-2% per year since the mid-1990s.
Advocacy group Fight Colorectal Cancer reports the incidence of early-age onset colorectal cancer – diagnoses under age 50 – is expected to increase by more than 140% by 2030. More than 27,000 people under age 50 will be diagnosed with colorectal cancer in 2030, up from 18,000 per year in 2020.
Experts say diagnosis in young people is often delayed, even though individuals present with classic symptoms of abdominal pain, rectal bleeding and changes in bowel habits.
Understanding Risk Factors
While the exact reasons behind the surge are not entirely clear, several contributing factors are believed to play a role, including:
- Genetic predisposition: The most common risk factor is a family history of colorectal cancer, Dr. Bista noted. About 25% of younger adults with the disease are thought to have genetic risk factors. These include certain genetic syndromes such as Lynch syndrome, familial adenomatous polyposis (FAP) and others.
- Unhealthy diet: This is characterized by overconsumption of processed foods, red meat and sugary beverages. A diet low in fiber and high in saturated fats can contribute to inflammation and damage to the colon and rectum over time.
- Sedentary lifestyle: Culprits include excessive screen time, prolonged sitting and reduced physical activity. Lack of exercise can lead to weight gain and obesity, which are known risk factors for the disease.
- Environmental factors: These include pollution, exposure to harmful chemicals and increased use of antibiotics. These factors can disrupt the balance of gut bacteria and promote the growth of cancerous cells.
“In recent years in Northeast Wisconsin, as in other parts of the country, we have seen more obesity and sedentary lifestyles among children and adolescents,” Dr. Bista said. “We must understand how these factors can lead to an increased risk for early-onset colorectal cancer.”
Prevention and Early Detection
Despite the concerning trend, younger adults can take steps to help reduce their risk of developing colorectal cancer and detect the disease early, including:
- Healthy lifestyle choices: This includes getting regular exercise, eating a balanced, high-fiber diet, and maintaining a healthy weight. Limit the consumption of processed meats and alcohol, and quit smoking.
- Regular screenings: While routine screenings for colorectal cancer typically begins at age 45, people with a family history of the disease or other risk factors may need to start screening at an earlier age. Colonoscopies are considered the “gold standard” for detecting the disease. Other options include fecal occult blood tests and stool DNA tests.
- Awareness and education: Colorectal cancer begins as an abnormal growth known as a polyp, typically in the large intestine. It could become malignant and spread throughout the body. Among younger patients, there is a higher incidence of the cancer on the left side of the colon and rectum, so the main symptoms typically are bright red blood in the stool and abdominal pain. These symptoms could mimic less-severe medical conditions such as hemorrhoids or constipation.
“If any of these symptoms persist for weeks or recur, see your primary care physician,” Dr. Bista said. “They might refer you to a surgeon or gastroenterologist specialist for a more detailed examination.”
Don’t Delay Care
The American Cancer Society found that about four in 10 people of eligible age are not up to date on colorectal cancer screening.
Dr. Bista explained that if screenings are delayed, it can lead to a diagnosis at an advanced stage in younger people. This can significantly decrease the rate of care and survivorship. In addition, as these individuals age, they can have an elevated risk of cancer for the rest of their lives.
“Knowledge is power,” Dr. Bista said. “By arming ourselves with awareness and taking proactive steps, we can work toward reversing this trend and protecting the health of future generations.”
For more information about scheduling an appointment for a colonoscopy, visit ThedaCare.org/services/cancer-and-blood-disorders/screenings-prevention/colonoscopy-screening/.
