- A new study found an increasing amount of younger adults are being diagnosed with colorectal, rectal, and colon cancer.
- The research found those in their 20’s had a 133% increase in rectal-only, distant-stage cancer over a 16 year period.
- Doctors continue to encourage getting colon cancer screenings and talking to your doctor about family health history.
A younger generation of Americans is being diagnosed with advanced stages of colorectal, rectal, and colon cancer, according to a new study published in the journal Cancer, Epidemiology, Biomarkers, & Prevention. And doctors aren’t quite sure why the disease is now impacting those in their 20’s and 30’s so aggressively.
Researchers looked at 16 years of data from nearly 104,000 patients who developed a subtype of colorectal cancer that is extremely aggressive called adenocarcinoma. Data was pulled from the Surveillance Epidemiology and End Results. The team looked for trends based on the stage of cancer, age, type of cancer (colorectal, rectal-only, or colon-only), and race of the patient. Data was broken down into three-year periods of 2000 to 2002 and 2014 to 2016.
Ultimately, the study found that those in their 20’s are being diagnosed with later-stage (and harder to treat) cancers—more so than ever before. Researchers noted that people in their 20’s had a 133% increase in rectal-only, distant stage cancer, while participants in their 30’s had a 97% increase, and those in their 40’s saw a 48% increase.
The study also found that Americans in their 30’s had a 49% increase in colon-only distant adenocarcinoma.
But age wasn’t the only factor. Researchers noted great disparities among racial groups, too. Those who identify as American Indian/Alaskan Native and Asian or Pacific Islander had very low representation and were ultimately excluded from the study. But Black and Hispanic Americans in their 20’s had the highest rate of late-stage cancer among all reported groups.
Wait, what is colon cancer?
Colorectal cancer is the third most diagnosed cancer in both men and women in the United States and the second most common cause of cancer deaths. Also called colon cancer or rectal cancer depending on where the cancer starts, it is classified by cells that grow out of control in the colon and rectum. The majority of colorectal cancers start as a growth (called a polyp) inside the lining of the colon or rectum. These polyps may develop into cancer over time, according to the American Cancer Society. Colon cancer can be diagnosed at any age, according to the Mayo Clinic, but it tends to most often affect people older than 50.
Why are younger people getting diagnosed more often?
Unfortunately, there’s no perfect answer to this as more research is needed. Recent studies suggest diet, including sugary drinks, could increase one’s risk for colorectal cancer. Niket Sonpal, M.D., assistant professor of medicine at Touro College Osteopathic Medicine and associate program director, internal medicine residency at Brookdale University Hospital and Medical Center, says that it’s possible a modern diet that focuses on higher fats and meats instead of fruits and vegetables may also be a contributing factor.
Andrew Vorenberg, M.D., a board-certified colon and rectal surgeon at Colon and Rectal Specialists agrees, adding that there’s likely something in our environment, like our diet, that is interacting with our gut and causing these mutations to occur. Historically, doctors have seen it take a while for the cell mutations to accumulate enough to cause cancer, which is the type of cancer is often found in older patients. But, as younger patients are developing the type of cancer more and more, specifically such a dramatic, aggressive form, he hypothesizes there’s an outside factor science hasn’t quite found yet.
“It’s really unusual. And it’s alarming,” Dr. Vorenberg says of the research. He adds that it’s also possible younger patients are ignoring symptoms, allowing for the disease to mutate and spread much more aggressively.
Harvey Kaufman, M.D., senior medical director of Quest Diagnostics adds that colorectal cancer has a link to weight, and given adolescent obesity rates are on the rise, there could be a connection there. Though, more research is needed to classify this as a definitive link.
Colorectal cancer risk factors
The number one risk factor doctors point to for colorectal cancer is age, explains Dr. Sonpal. “The older we get, the more likely we are to get polyps,” he says.
The second most important risk factor for colorectal cancer is your family history. “It’s not comfortable to talk about, but understand who in your family has passed away or had colon or rectal cancer,” Dr. Sonpal suggests. If you have a first or second-degree relative that has been diagnosed with colorectal cancer, you’ll likely need to start your screenings even earlier than the recommended 45 years old, he adds.
Other risk factors include lifestyle risks like alcohol and tobacco use or being overweight, adds Dr. Kaufman. Though more research is needed, Dr. Sonpal suggests diet could also play a big role in colorectal cancer risk. Things like a lack of fiber in the modern Western diet could potentially be connected, but there’s not enough evidence to support that at this time.
Colorectal cancer symptoms
Colorectal cancer doesn’t always present itself in obvious symptoms, warns Dr. Kaufman. But, some common colon cancer symptoms include:
- A change in the quality of your stool, meaning it appears different or the frequency has changed dramatically, explains Dr. Sonpal.
- Bloody stool is another very common sign of something off in your gut. But this may not appear so obvious every time you go to the bathroom. Dr. Sonpal explains that sometimes this manifests as microscopic blood in the stool, and your doctor will likely see this as anemia during a routine blood test.
- Pain or constipation are rarer, and likely only occur during very advanced stages of colorectal cancer, Dr. Sonpal adds.
How to prevent colorectal cancer
In late 2020, the U.S. Preventive Services Task Force changed the colorectal cancer screening guidelines to recommend getting screened as early as 45 years old. Previously, the task force recommended beginning screenings at age 50.
And doctors agree that there is nothing more important in the prevention of colorectal cancer than getting your screening. Dr. Sonpal explains that these tests can help identify small polyps in your colon or rectum early on, so doctors can remove them before they have the opportunity to become cancerous. Based on the results of your screening, your doctor can help you figure out how frequently you should be screened.
“Something I want to stress is the importance of earlier screenings and that everyone, including younger patients, [is] informed of potential symptoms and if their family history may be putting them at a higher risk,” Dr. Kaufman says. “Getting the appropriate screenings and understanding your family health history are crucial for early detection and possible prevention.”