If you’re under the age of 50, colorectal cancer or bowel cancer may not be at the forefront of your mind. However, recently published data shows that despite your age, there’s an increasing incidence of colorectal cancer in those younger than 50.
In the journal Cancer, published this month by the American Cancer Society, scientists are finding that the incidence of colorectal cancer in adults younger than 50 has increased in the United States over the past decade.
A rising risk for younger people
The study identified over 130,000 patients who were diagnosed under the age of 50. Over 1 million patients were diagnosed at the age of 50 and above. In those diagnosed under the age of 50, there was an increase in the number of cases from 2004 to 2015.
In all cases of colorectal cancer that were diagnosed, 10 percent were under 50 in 2004. That number rose to 12.2 percent in 2015. At the time of initial diagnosis, younger patients presented with more advanced stages of the disease — over 50 percent had stage 3 or 4.
Of those diagnosed younger than 50 years old, there’s an even higher incidence in African Americans (13.9 percent) and Hispanic populations (18.9 percent).
A 2014 study published in the journal JAMA Surgery predicts that by 2030, the number of colon cancer cases in those between 20 and 34 years old will increase by 90 percent, and rectal cancer will increase by 124.2 percent.
Colorectal cancer is the third leading cause of cancer-related deaths in the United States that affect both men and women, according to the Centers for Disease Control and PreventionTrusted Source. Despite this prevalence, the overall rate of new cancer diagnoses and cancer deaths in all ages has steadily decreased since 2009. Experts believe this is because of advancements in screening and management of the condition.
Dr. Nancy You, associate professor of surgical oncology at MD Anderson Cancer Center, University of Texas, tells Healthline there are several contributing factors to the overall decline. “These are encouraging trends of progress, and they reflect the collective achievement of our entire society. Previous modeling studies have shown that there are three main contributors: advances in treatment, risk factor identification and modifications, and cancer screening practices.”
Why are rates increasing?
Currently it isn’t known why younger populations are experiencing colorectal cancer. You said that she believes, “Significantly more young-onset colorectal cancers arise from hereditary cancer syndromes (i.e. inherited mutation in cancer-predisposing genes), and significantly more arise in association with a family history.” But there isn’t an apparent cause in the majority of patients.
The American Cancer Society updated its guidelines for colorectal cancer screening in 2018. Previously, the guidelines recommended screening to begin at the age of 50 for people with an average risk. However, new guidelines recommend screening at the age of 45.
The more people know about colorectal cancer, the more likely they are going to get checked.
“There is an increased awareness about the importance of screening whether it be via testing stool, flex sigmoidoscopy, or full colonoscopy. I definitely think there is increased social media awareness as well,” says Dr. Cathy Eng, co-leader of the VICC Gastrointestinal Cancer Research Program at Vanderbilt University Medical Center.
Screening tests are important to consider in assessing an incidence of colorectal cancer. There are both stool-based and visual exam tests available.
Some stool-based sampling includes testing every year, while others test every three years. Visual examinations include getting a colonoscopy every 10 years and using a CT scan or flexible sigmoidoscopy every five years. Although there are several options available, it’s best to talk to a physician to determine which is the right test for you.
Although the authors of the study have no definitive reason as to the increase in prevalence, they predict it’s due to a lack of screening. “Because of the lack of screening, younger patients are more likely to present with and die of advanced disease. These data should be considered in the ongoing discussion of screening guidelines.”
Signs of colorectal cancer
Colorectal cancer signs and symptoms can be subtle or even very alarming. Being aware and vigilant of changes can be the warning signs needed to catch the cancer in its early stages.
According to You, here are some symptoms to watch out for:
changes in bowel patterns, including size or shape
losing weight without dieting
increased straining with bowel movements
fatigue or reduced exercise stamina
discomfort or urge to have a bowel movement when there’s no need
bloating or feeling full
It’s never too early to consider the risks and preventive measures against colorectal cancer.
“Historically, colorectal cancer impacts individuals in their mid- to late 60s. However, 15 percent of patients are under 50 years old,” said Eng. “It is expected that there will be a rise in the colon and rectal cancer in young patients in the next decade. This is a preventable cancer. Get screened if age-appropriate, or go visit your doctor if you are having any symptoms. Any screening is better than no screening.”
Rajiv Bahl, MD, MBA, MS, is an emergency medicine physician and health writer.