Colon and Rec­tal Cancers Ris­ing in Young Peo­ple

The Star (St. Lucia) - - IN­TER­NA­TIONAL -

Cancers of the colon and rec­tum have been de­clin­ing in older adults in re­cent decades and have al­ways been con­sid­ered rare in young peo­ple. But sci­en­tists are re­port­ing a sharp rise in col­orec­tal cancers in adults as young as their 20s and 30s, an omi­nous trend.

The vast ma­jor­ity of col­orec­tal cancers are still found in older peo­ple, with nearly 90 per­cent of all cases di­ag­nosed in peo­ple over 50. But a new study from the Amer­i­can Can­cer So­ci­ety that an­a­lyzed can­cer in­ci­dence by birth year found that col­orec­tal can­cer rates, which had dropped steadily for peo­ple born be­tween 1890 and 1950, have been in­creas­ing for ev­ery gen­er­a­tion born since 1950. Ex­perts aren’t sure why.

Rec­tal cancers are ris­ing par­tic­u­larly sharply, far faster than cancers in other parts of the large in­tes­tine or colon. The Amer­i­can Can­cer So­ci­ety es­ti­mates 13,500 new cases of colon and rec­tal cancers will be di­ag­nosed in Amer­i­cans un­der 50 this year, with more than 95,500 cases of colon can­cer and nearly 40,000 cases of rec­tal can­cer in all age groups.

“Peo­ple born in 1990, like my son, have dou­ble the risk of colon can­cer and quadru­ple the risk of rec­tal can­cer” com­pared to the risk some­one born in 1950 faced at a com­pa­ra­ble age, said Re­becca Siegel, an epi­demi­ol­o­gist with the Amer­i­can Can­cer So­ci­ety and the lead au­thor of the new re­port, pub­lished in the Jour­nal of the Na­tional Can­cer In­sti­tute on Tues­day. And though the ab­so­lute risk is still small in younger peo­ple, she said, “They carry the risk for­ward with them as they age.”

It is the up­ward trend that is wor­ri­some: The risk of colon can­cer for in­di­vid­u­als who were born in 1990 was five per mil­lion peo­ple in that birth group, up from three per mil­lion at the same stage of life for those born in 1950. And the risk of rec­tal can­cer for those born in 1990 was four per mil­lion, up from 0.9 per mil­lion for those born in 1950.

Dr. Thomas Weber, a pro­fes­sor of surgery at SUNY Down­state Medical Cen­ter who has served on the Na­tional Col­orec­tal Can­cer Round­table and who was not in­volved in the new study, said the lat­est re­search con­firms the prob­lem is­resl and in­creas­ing. “There is no mis­tak­ing these dra­matic in­creases, es­pe­cially for rec­tal cancers,” he said, not­ing that the num­ber of new col­orec­tal cancers among peo­ple un­der 50 each year ex­ceeds the to­tal num­ber of new cases of less com­mon cancers like Hodgkin’s lym­phoma.

Young peo­ple with col­orec­tal can­cer run the added risk of get­ting a di­ag­no­sis later in the course of their dis­ease, when the can­cer may be less treat­able, be­cause doc­tors typ­i­cally don’t con­sider the di­ag­no­sis at such a young age. Most col­orec­tal cancers are con­sid­ered a dis­ease of ag­ing, so any in­crease in young adults, es­pe­cially when rates of the dis­ease are on the wane in older peo­ple, is both baf­fling and wor­ri­some, ex­perts say.

Col­orec­tal can­cer rates have de­clined over­all in re­cent years thanks to wide­spread use of screen­ing tests like colono­scopies, which can de­tect pre­can­cer­ous polyps that can be re­moved be­fore can­cer de­vel­ops. These screen­ing tests have not been con­sid­ered prac­ti­cal for a younger pop­u­la­tion, and while other less in­va­sive screen­ing tests ex­ist, doc­tors are hop­ing for im­proved meth­ods that will be eas­ier to ad­min­is­ter.

Ex­perts also at­tribute low­er­ing can­cer rates to changes in risk fac­tors, par­tic­u­larly life­style changes like smok­ing ces­sa­tion and health­ier di­ets. Di­ets that in­clude more fruits, veg­eta­bles and fiber and less red and pro­cessed meat are linked to lower col­orec­tal can­cer risk.

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