Colon cancer affecting younger adults

Colorectal cancer knows no boundaries. While it is still most frequently diagnosed in people over age 65, the numbers are changing. Healthcare experts call it an alarming trend.

In early 2023, the American Cancer Society (ACS) reported that 20 percent of colorectal cancer diagnoses in 2019 were in patients under age 55 – nearly double the rate in 1995. Also, the rates of advanced colorectal cancer increased by about 3 percent annually in adults younger than 50.

Colorectal cancer is the third most diagnosed cancer and the third leading cause of cancer death in American men and women. The disease declined rapidly in people 50 and older during the 2000s, largely because of increased colonoscopy screening, which can prevent cancer by removing premalignant polyps. However, this progress has slowed over the past decade with decreasing trends now confined to people 65 and older.

According to Yale Medicine, no one knows for sure why colorectal cancer is rising in younger people. Other experts agree and say more research is needed. Sedentary lifestyle, overweight and obesity, smoking, heavy alcohol use, low-fiber, high-fat diets or diets high in processed meats, and other environmental factors have all been associated with the disease. Family history of colorectal cancer or polyps, and conditions such as inflammatory bowel disease, are also risk factors.

Colonoscopy is considered one of the biggest reasons for the overall decrease in colorectal cancer. Even though the disease is rising in younger people, the incidence is still too low to justify routine colonoscopies for them, according to Yale Medicine. It states, “Once a screening test is developed for a disease, it is important to make sure that the number of screenings performed will prevent enough cancers to justify the costs and risks associated with the tests.”

In 2021, the US Preventive Services Task Force issued a new recommendation that colorectal cancer screening for people at average risk begin at age 45 instead of 50. The change was based on the trend of growing cases among younger adults.

Currently, ACS screening guidelines for people at average risk for colorectal cancer using colonoscopy are:

• Age 45-75: Every 10 years
• Age 76-85: Screening based on personal preference, life expectancy, overall health & prior screening history
• Over age 85: Screening not recommended

Symptoms of Colorectal Cancer

• A change in bowel habits; more frequent diarrhea or constipation
• Rectal bleeding or blood in the stool
• Ongoing discomfort in the stomach area (cramps, gas, pain)
• A feeling the bowel does not empty all the way during a bowel movement
• Weakness or tiredness
• Losing weight without trying

A screening colonoscopy remains the gold standard for the prevention of colorectal cancer.