Colon cancer rising in younger people, report says

Rate in those younger than 55 nearly doubles

The burden of colorectal cancer in the United States is shifting to younger adults, and more patients are being diagnosed with later stage disease, according to a concerning new report from the American Cancer Society.

One in five new cases of colorectal cancer in the United States occur in people younger than 55 — about twice the rate in 1995, when 11 percent of cases were in this age group. In another alarming shift, 60 percent of patients are being diagnosed with an advanced stage of the disease, up from 52 percent in the mid-2000s.

The reasons behind the trends aren’t fully understood, but the findings suggest that steady progress to reduce the incidence of colon cancer through screening during the past few decades is losing momentum.

“There is a bit of a worrisome trend,” said Paul Oberstein, a medical oncologist at the NYU Langone Perlmutter Cancer Center who was not involved in the study. “Something is clearly different among the young, the under 50 population, that does suggest, although it’s small, that the number of cancers are going up.”

Overall, colorectal cancer is on the decline, largely because more people over 50 are being screened by colonoscopy, which can prevent cancer by detecting and removing premalignant polyps. Recently, the US Preventive Services Task Force recommended lowering the age for colorectal cancer screen to 45.

But the new report “foreshadows less favorable trends ahead,” the study authors wrote, with more patients being diagnosed at younger ages and with more advanced disease.

The report, based on the latest available data through 2019, shows the gains against the disease are limited to people 65 and older. Here are some of the findings:

■ Incidence rates have increased by 2 percent per year in people younger than 50.

■ More people younger than 50 are dying from the disease. Since 2004, death rates in this age group have increased by about 1 percent annually.

■ More patients overall are being diagnosed with regional or distant disease, which means it has spread beyond the colon to nearby or distant lymph nodes, tissues, or organs. The incidence of regional stage and distant stage disease has increased by about 3 percent per year in people younger than 50, while rates have stabilized in people age 65 and up after a decade of decline.

■ Overall, men are at higher risk than women. The incidence rate of colorectal cancer was 41.5 per 100,000 in men compared with 31.2 in women.

■ The disease disproportionately affects people of color. Incidence rates are highest in Indigenous Alaskans (88.5 per 100,000), Native Americans (46 per 100,000), and Black people (41.7 per 100,000). By comparison, the incidence rate in whites is 35.7 per 100,000.