Colorectal cancer, once largely considered a disease of older adults, is increasingly affecting younger men and women, now ranking as the leading cause of cancer death for Americans under 50. This concerning trend is highlighted by the recent deaths of actor James Van Der Beek, age 48, and, several years prior, actor Chadwick Boseman, age 43.
The rising incidence of this cancer in younger populations is prompting concern among medical professionals. “We’re now starting to notice more and more people in the 20-, 30- and 40-year-old range developing colon cancer. At the beginning of my career, nobody that age had colorectal cancer,” said Dr. John Marshall of Georgetown University’s Lombardi Comprehensive Cancer Center, a cancer doctor with over three decades of experience. This shift, he added, “is shaking us all, to be blunt,” and is a critical area of ongoing investigation.
More than 158,000 cases of colorectal cancer are expected to be diagnosed in the U.S. This year, according to the American Cancer Society. While it remains the nation’s second leading cause of cancer death overall – behind lung cancer, which is projected to claim over 55,000 lives this year – the increase in cases among younger adults is particularly alarming. Early detection is crucial, as survival rates are significantly higher when tumors are identified and treated in their early stages.
Recent research indicates that survival rates can range from 80% to 90% when colorectal cancer is detected early. However, when diagnosed in advanced stages, after the cancer has spread, survival rates can drop to as low as 10% to 15%, underscoring the importance of proactive screening.
How Common is Colorectal Cancer?
While the majority of colorectal cancer cases and deaths still occur in individuals 50 and older, this demographic has seen a decline in mortality rates of approximately 1.5% annually over the past decade. However, diagnoses among those under 50 have been steadily increasing since the early 2000s. Last month, researchers reported that colorectal cancer mortality in Americans under 50 had increased by 1.1% each year since 2005, making it the most deadly cancer in that age group. This year, an estimated 3,890 Americans under 50 will die from the disease.
Several factors can increase a person’s risk of developing colorectal cancer, including obesity, a lack of physical activity, a diet high in red or processed meat and low in fruits and vegetables, smoking, excessive alcohol consumption, inflammatory bowel disease, and a family history of the disease. Recent studies have also linked increased consumption of ultra-processed foods to a higher risk, though more research is needed to confirm a direct causal link.
Dr. Marshall recommends a diet rich in fruits, vegetables, and whole grains. “Meat isn’t bad,” he said, “but you have to eat less of it.” A recent study also found that a three-year exercise program improved survival rates in patients with colon cancer and reduced cancer recurrence.
What are the Symptoms of Colorectal Cancer?
Symptoms of colorectal cancer can include blood in the stool or rectal bleeding, changes in bowel habits such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days, unexplained weight loss, and abdominal cramps or pain. Anemia without a clear cause, detected through blood tests, can also be a sign.
“Don’t ignore the symptoms. Obtain checked out,” Marshall emphasized. Early diagnosis significantly improves the chances of successful treatment.
When to Get Screened for Colorectal Cancer
Current medical guidelines recommend that average-risk individuals begin screening at age 45. However, some experts suggest this may be too late for certain young adults. Individuals with known risk factors should discuss with their doctors whether to begin screening even earlier.
The frequency of screening depends on the type of test chosen. Options include annual stool tests or colonoscopies, which can be performed every 10 years if no issues are found. A newer blood test is also available for adults 45 and older. Individuals at high risk – due to family history, hereditary conditions, or inflammatory bowel disease – typically require more frequent and earlier colonoscopies.
What is Causing the Increase in Colorectal Cancer in Younger Adults?
The exact cause of the increase in cases among younger adults remains unknown. Dr. Marshall noted that many young patients lack the common risk factors typically associated with the disease. He wonders if changes in young people’s gut bacteria – the microbiome – could play a role.
Other researchers are investigating the potential role of gut microbiota imbalances, known as dysbiosis, which can lead to inflammation and negative health effects, including an increased risk of cancer. The location of the cancer within the colon – whether it begins on one side of the abdomen and curves toward the other before ending with the rectum – can influence its aggressiveness and treatment. Marshall said there is a noticeable difference in where tumors tend to appear in younger versus older individuals, another clue being explored.
FEW (AP, The Conversation)
