Colon cancer increasing in young people
Adults in the United States are being diagnosed with colon and rectal cancers at younger ages, and a greater share of cases are being found when the cancer is already at an advanced stage, according to a new report.
Adults younger than 55 accounted for 20 percent of all colorectal cancer cases diagnosed in 2019, up from 11 percent in 1995, according to data from the American Cancer Society.
The data was released recently in an annual report that tracks facts and trends for colon and rectal cancers.
In addition, 60 percent of all colorectal cancer cases diagnosed in 2019 were already at an advanced stage, up from 52 percent in the mid-2000s, according to the report.
That’s important because there’s a higher chance of successful treatment if colorectal cancer is caught at an early stage.
It’s unclear what is causing the rising incidence rate in younger adults, the ACS said.
The trend could be related to lifestyle factors; diets that are high in red meat and processed meats, a lack of exercise, being overweight and smoking are all risk factors for colorectal cancer, said Dr. Sahil Mittal, a gastroenterologist at Kelsey-seybold Clinic.
“One possible thing which we have been seeing overall in the younger population, the role of diet and the role of weight … obesity is on the rise in the U.S.,” Mittal said. “We don’t know, but I think those could be the possible factors.”
The ACS called for more research to uncover the cause, as well as to discover newer treatments for advanced-stage colorectal cancer.
Recently there have been several high-profile instances of colon cancer being diagnosed in adults younger than 45.
“Black Panther” star Chadwick Boseman was 43 when he died of colon cancer in 2020, and Broadway actor Quentin Oliver Lee was 34 when he died of colon cancer last year.
The report also illustrates the importance of regular screening for colorectal cancer, including a colonoscopy every 10 years beginning at age 45, the ACS said.
“We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population,” Rebecca Siegel, the senior scientific director at the ACS and the lead author of the report, said in a statement.
“The trend toward more advanced disease in people of all ages is also surprising and should motivate everyone 45 and older to get screened.”
What do the numbers say?
The report outlined other key facts and trends about colorectal cancer in the United States. Among them:
• Among people under 50, mortality rates have increased about 1 percent annually since 2005. Among people 50 to 54, they’ve increased about 0.6 percent annually during that same time frame.
• Over the past decade, the incidence rate of colon cancer has fallen about 1 percent per year, while the mortality rate has fallen about 2 percent. In the 2000s, incidence and mortality rates fell by about 3 to 4 percent per year.
• Among people 65 and older, incidence rates have declined since 2011; the report does not specify how much they’ve fallen.
• Among people 50 to 64 and 50 to 54, incidence rates have increased about 2 percent per year since 2011.
• The incidence rate was about 33 percent higher in men (41.5 cases per 100,000) than women (31.2 cases per 100,000) from 2015-19.
• Incidence rates are highest among people who are Alaska Native (88.5 cases per 100,000), American Indian (46 per 100,000) or Black (35.7 per 100,000).
• Mortality rates are highest among people who are Alaska Native (50.5 cases per 100,000), American Indian (17.5 per 100,000) or Black (17.6 per 100,000).
What to know about colorectal cancer
Colorectal cancers are the third-most-common type of cancer diagnosed in both men and women in the U.S., excluding skin cancer. The ACS estimates there will be 106,970 new cases of colon cancer and 46,050 new cases of rectal cancer diagnosed in 2023.
Colorectal cancer is expected to cause about 52,550 deaths in the U.S. this year, according to the ACS.
Certain factors can increase someone’s risk for colorectal cancer. Some of them are unavoidable; they include age, race or ethnicity and a family history of colorectal cancer. But lifestyle factors such as being overweight or obese, not exercising, eating too much red meat or processed meat and smoking also can increase someone’s risk.
Treatment depends on the stage of the cancer.
Surgery can be used at an early stage, but later stages may require radiation or chemotherapy.
If the cancer is localized, the five-year survival rate for colorectal cancer is 91 percent.
The survival rate drops to 72 percent if it has spread to nearby tissue or lymph nodes, and 19 percent if the cancer has spread to distant lymph nodes or organs like the liver or lungs.
“If the stage is further down, the chances of a cure will go down,” Mittal said. “It’s better to get it detected and get it treated at an earlier stage.”
When to get checked out
Screening for colorectal cancer starts with a colonoscopy at age 45, then another every 10 years until at least age 75.
Many people with colon cancer will not experience any symptoms in the early stages, which is why screenings are needed.
But some warning signs may need to be checked out sooner.
They include rectal bleeding or blood in the stool; a persistent change in your bowel habits; unexplained weight loss; or persistent abdominal discomfort.
Hemorrhoids also can cause rectal bleeding, but Mittal cautioned against assuming they are the cause.
“Sometimes people ignore it, they think ‘hemorrhoids,’ ” Mittal said. “Any bleeding — rectal bleeding, blood in the stool — should be investigated. They should seek help and see a doctor.”