Uptick in colon cancer rates among people under 50

Call for gastric surgery to be standard diabetes treatment

LOS ANGELES, May 25, (Agencies): Colon cancer among people under 50 is on the rise, and tumors are often diagnosed at an advanced stage, according to research presented Tuesday.

The findings were based on a US study of more than a million people over the course of 10 years. They were presented during Digestive Disease Week, a medical conference in San Diego, California.

“While the healthcare system has done a great deal to address colorectal cancer in people over 50 — heightening patient awareness and increasing screenings — our findings show that much more needs to be done to fight this cancer in people under 50, a group not normally considered at risk,” said lead author Elie Sutton, a research fellow at Mt. Sinai West Hospital in New York.

“Not only did we find that the rate of colorectal cancer in this group is rising, we also saw that within the group that was diagnosed at a younger age, a higher percentage were diagnosed at later stages of cancer (stage three or four), which is very concerning,” she added.

Over the decade of research, the number of colon cancer cases in under-50s rose by 11.4 percent, about 136 new cases every year.

This rise among young people comes even as overall colon cancer rates have been declining in recent years.

The study found colon cancer rates in those older than 50 fell by 2.5 percent in the same time period.

Despite the rise among the young, doctors pointed out that the overwhelming majority of colon cancer cases still occur in people over 50.

Colon cancer often begins as a polyp, or a growth, inside the colon or rectum.

The main tool for prevention is a colonat

oscopy, which allows doctors to find and remove these polyps.

But often, symptoms only appear after the cancer has begun to grow, and these signs — such as rectal bleeding, constipation or diarrhea that lasts more than a few days — can be mistaken for other ailments.

Colorectal cancer is the third most common cancer in the United States, with more than 132,000 new cases in 2015.

It was also the second-leading cause of cancer death, after lung cancer.

Sutton’s study found that by the time of diagnosis, younger cancer patients tended to have more advanced cancers than older

patients.

Nearly 31 percent of younger patients were diagnosed at stage three, compared to 25.1 percent of older patients.

One-quarter of patients under 50 were diagnosed at stage four, compared to 18.2 percent of older patients.

Colon cancer in younger patients also occurred more frequently among nonwhite patients than in Caucasians.

The US National Cancer Database provided the data from 2004 to 2013, and it echoes a trend found in a previous study about five years ago.

“Between the time of the previous research and our study, we still have not

adequately addressed the risk of colorectal cancer in people under the age of 50,” Sutton said. “It’s critical that we reverse this trend so that we are able to reduce, and hopefully eliminate it in all populations, regardless of age.”

People with diabetes should be offered gastric surgery as a standard treatment option which could help control it for years without medication, the world’s leading diabetes groups said.

A joint statement from a 45-strong group said on Tuesday that bariatric, or metabolic, surgery could have a significant

benefit for hundreds of thousands of patients worldwide, which they said represented one of the biggest shifts in diabetes treatment guidelines since the advent of insulin.

The new guidelines say surgery to reduce the stomach and induce weight loss should be recommended to treat all diabetes patients whose body mass index (BMI) is 40 or over, regardless of their blood glucose control, as well as those with a BMI of 30 and over whose blood sugar levels are not being controlled by lifestyle changes or medication.

Francesco Rubin, a professor and chair of metabolic and bariatric surgery King’s College London and one of the authors of the new guidelines, said many countries across the world are in the midst of “an epidemic of diabetes”.

Rubino said patients should be offered a range of options, including lifestyle changes, medications and surgery.

“For some, surgery may be the best choice,” he told a briefing in London.

Type 2 diabetes is characterised by insulin resistance, which many can manage with medication and diet. But the disease is often life-long and a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

A recent World Health Organisation study found that the number of adults with diabetes has quadrupled in the past four decades to 422 million. International Diabetes Federation (IDF) estimates that by 2040 this will rise to 642 million.

“Surgery represents a radical departure from conventional approaches to diabetes,” Rubino said.

The guidelines, published in the journal Diabetes Care, were endorsed by 45 international organisations, diabetes specialists and researchers, including the IDF, the American Diabetes Association, the Chinese Diabetes Society and Diabetes India.

The guidelines are based on a substantial body of evidence, including 11 randomised trials, showing that in most cases surgery can lead to reductions in blood glucose levels below the Type 2 diabetes diagnosis threshold or to a substantial improvement in blood glucose levels.

In many cases this would lead to patients being able to give up or significantly reduce their diabetes medications.

Novo Nordisk, Sanofi and Eli Lilly are the world’s leading suppliers of insulin and other diabetes drugs.