Colorectal Cancer in Young Adults: On the Rise?

Colorectal Cancer by the Numbers

Colorectal cancer is the third most commonly diagnosed cancer in males and the second most commonly diagnosed in females, with 1.4 million new cases in 2012 and 694,000 deaths worldwide. In the United States alone, approximately 135,000 cases are diagnosed annually. Fortunately, due to increased awareness and access to colorectal cancer screening, the rates of diagnosis and death have declined significantly over the past 20 years. While colorectal cancers account for 8% of cancer related deaths in this country, recent data suggests an increase in the diagnosis of colorectal cancer in patients under the age of 50, although the overall occurrence of colorectal cancer in this age group remains low compared to people over the age of 50. Patients who have an increased risk of developing colorectal cancer include those with certain genetic syndromes (e.g. Familial adenomatous polyposis and Lynch syndrome), those with a family history of colorectal cancer, and patients with inflammatory bowel disease (e.g. Crohn’s disease and Ulcerative Colitis).

Cancer’s Prevalence in Younger Patients

In a study published in the Journal of the National Cancer Institute earlier this year, researchers looked to further understand the increasing rates of this type of cancer in younger patients. In the study, they looked at 500,000 people between 1974 and 2013 who were diagnosed with colon or rectal cancer at age 20 or older. What they found was that rates of colon and rectal cancer diagnosis increased every year for people ages 20-39, slightly more than people ages 40-54. While these increases were only very small percentages per year, this does translate to a significant number of people in our country.

Why is it on the Rise?

People younger than age 50 are also more likely to be diagnosed with advanced stage disease, meaning the cancer has spread beyond the colon. Symptoms can be non-specific and include weakness, fatigue, abdominal pain and weight loss. They can also be more alarming and include blood in the stool, black stools, constipation, or inability to move the bowels, and changes in the stool appearance (loose or thin stools). Symptoms are sometimes ignored by younger patients who may wait longer to seek care. It is important to discuss with your physician if you experience any of these symptoms, particularly if they last more than several days. Colon and rectal cancer are typically diagnosed by colonoscopy, but other diagnostic tests including blood work, imaging, and stool tests may also aid in the diagnosis.

Now that we are aware of the increasing rates of colon and rectal cancer diagnosis in younger patients, researchers are trying to determine why. Some possibilities include high-risk behaviors such as tobacco and alcohol use, and others include obesity and lack of regular exercise. Diet may also play a role, so it is important to eat a diet high in fruits, vegetables and whole grains while limiting intake of red and processed meats.

While colon and rectal cancers remain uncommon in patients under the age of 50, the rate of diagnosis in this population is increasing. It is imperative to be aware of the symptoms and talk with your physician if you experience any worrisome changes in your health. Early diagnosis is the key to better outcomes with treatment. It is also important to understand your family history in order to help your physician determine whether you require earlier colon cancer screening than what’s typically recommended. 

Bryan Kleinman, DO, earned his Medical Degree from New York College of Osteopathic Medicine in Old Westbury, NY and completed his Residency in Internal Medicine at The Ohio State University Wexner Medical Center in Columbus, OH.  He is Board Certified in Internal Medicine and completed Fellowship training in Gastroenterology at Einstein Medical Center in Philadelphia, PA.  Dr. Kleinman specializes in Gastroenterology.