Here’s why colon cancer cases are rising in young adults
November 1, 2018
Colorectal cancer cases are rising in adults in their 30s and 40s in the U.S. Unfortunately, we can’t single out a reason why. There's a chance that earlier screenings and healthier lifestyle choices could help curb this alarming trend, however.
Colorectal cancer arises from the inner lining of the large intestine, also known as mucosa. It usually begins as an abnormal growth, or polyp, that forms in the colon or rectum. Symptoms might not be readily apparent; rather, they show up as the disease progresses. Common symptoms can include:
- Abdominal pain
- Blood in the stool
- Decreased appetite
- Weight loss
These symptoms are vague when one considers the entire body system. However, it’s important that patients be aware of these symptoms and never assume they’re too young to get colorectal cancer. Studies show that younger people are more likely to be diagnosed with late-stage colorectal cancer because they assume their symptoms are due to something less serious. I’ve seen patients, for example, who experienced blood in their stool and figured it was hemorrhoids or had abdominal pain and thought it was irritable bowel syndrome.
Potential factors associated with colorectal cancer
1. Genetic diseases
Up to 35 percent of people who develop cancer before age 50 have genetic mutations, compared to 3 to 5 percent of all colorectal cases. These numbers suggest that genetics are affecting younger patients much more than older patients, but we need more research to say for sure.
Two common forms of genetic conditions we see in colorectal cancer patients include familial adenomatous polyposis (FAP), which is when hundreds of polyps cover the inner lining of the colon, and Lynch syndrome, which is a non-polyposis syndrome that increases risk of developing colorectal cancer and other malignancies.
Interesting research is happening now pertaining to genetic mutations that have yet to be identified. While we know many of the genetic mutations that lead to colorectal cancer, we don’t know them all. Identifying possible genetic mutations is extremely important to identify predisposition of the patient and their first relatives not only for colon cancers but other cancers to organs as well. Moreover, knowing if patients carry a specific genetic mutation might have implications in the type of surgery or chemotherapy needed. As it stands now, new genetic mutations are detected every few years. Therefore, patients who were tested a few years ago and had no genetic mutations could have a different result today. Keeping up with testing could not only help them but their relatives and children, as well. People can do so by scheduling a genetic counseling appointment.
It has been hypothesized for years that a low-fiber diet that’s high in animal protein and red meat can also increase colon cancer risk. We have no definitive evidence to support either of these theories, but patients’ overall health would only benefit from consuming a healthy diet that prioritizes fruits, vegetables, and high-grain fibers. Furthermore, new studies have suggested that certain foods can negatively affect the microbiome, or the bacteria population in the colon, which could result in a higher risk of colorectal cancer.
Heavy alcohol consumption, or more than two drinks per day for men and one drink per day for women, could be another important risk factor for colorectal cancer. I suggest patients make their best effort to prevent heavy drinking because it’s been associated with many different health implications.
Smoking cigarettes is a well-known cause of lung cancer, but it's associated with many other cancers, as well. In fact, studies show that individuals who smoke for long periods of time are more likely than non-smokers to develop colorectal cancer.
Obesity and excess body fat have been shown to be associated with increased incidence of colorectal cancer. Moreover, a recent study has shown that excess body fat at an early age might be associated with colon cancer risk later in life. Thus, preventing excess body fat and obesity in young individuals could be associated with early-onset colon cancer prevention. I suggest patients make it a goal to exercise for at least 30 minutes a day, four days a week.
5. Ulcerative colitis
Ulcerative colitis, or a type of inflammatory bowel disease, is a condition that causes long-lasting inflammation and sores in the innermost lining of the large intestine and rectum. Patients who have ulcerative colitis are at higher risk of colorectal cancer in comparison to the general population. These patients should work with a doctor to plan frequent colorectal cancer screenings to rule out the presence of the disease.
"These symptoms are vague when one considers the entire body system. However, it’s important that patients be aware of these symptoms and never assume they’re too young to get colorectal cancer. Studies show that younger people are more likely to be diagnosed with late-stage colorectal cancer because they assume their symptoms are due to something less serious."
Issues with diagnosing colon cancer in young adults
As of May 2018, the American Cancer Society’s recommendation was people at average risk start screenings at age 45, but this can be too late for someone who gets cancer in his or her 30s or 40s. This makes it especially important that patients see a doctor if they experience persistent symptoms – even if they’re younger than 45.
Patients with a family history of colorectal cancer should talk to their doctor about getting their first colonoscopy 10 years before the earliest onset of anybody in the family. That is, if a patient’s mother was diagnosed at 52, the patient should be getting screened at age 42. To ensure that insurance covers this, patients should speak with their doctor.
How colon cancer is diagnosed and treated
As with most cancers, the sooner colorectal cancer is diagnosed, the more likely that treatment will be effective. With a colonoscopy or similar screening, patients can have cancerous tumors detected early and removed, as well as polyps that have the potential to turn into cancer. Polyps are small tissue growths commonly found arising from inner lining of the colon.
Colorectal cancer treatment varies among patients based on tumor type and location, as well as on a patient’s overall health and lifestyle. Typically, we recommend a combination of surgery (usually a minimally invasive procedure), chemotherapy, and radiation depending on each individual case.
Given the growing number of colorectal cancer cases in young adults, it is important to be aware of potential risks factors, symptoms, and guideline recommendations to detect the disease at an early stage.