4 days ago
Colorectal cancer: Why more people under 50 are at risk
Damien Scogin learned that colorectal cancer (CRC) can develop in younger and healthy people when his close friend passed from the disease after she was diagnosed in her late 30s. His friend urged him and others to get colorectal screenings and convinced him to get a colonoscopy in his mid-40s after he experienced mild symptoms that were initially attributed to other conditions.
No one is ever prepared to learn they have cancer. Damien says, 'I'm a huge outdoor sports enthusiast. I've always stayed very fit and eat a low-risk diet that is more or less vegetarian.' When the colonoscopy revealed he had advanced colon cancer, 'it was like a hammer hit me in the skull,' he says.
Damien is part of a disturbing trend: A persistent rise over the last several years of people under 50 developing cancer in the colon or rectum. Research shows the number of cases is growing in people as young as their 20s and 30s — and the death rate from colorectal cancer for people ages 20 to 54 rose between 2004 and 2014 after previously declining. Because younger patients present with symptoms, early onset CRC is often diagnosed at advanced stages with a poor prognosis. Young people must understand the factors behind this shift and take preventive measures.
CRC is a collective term to describe cancers that affect the colon (the large intestine), and rectum (the last part of the large intestine, before the anus). This cancer typically takes years to grow and often begins as a small growth (polyp) on the lining of the organ. While it is usually contained within the intestine, it may spread to other organs, such as the liver and lungs without timely intervention.
The most common symptoms of early onset CRC blood in stools, abdominal pain or cramps, and, change in bathroom habits (constipation, diarrhoea, or narrow stools that may persist for several weeks). Other symptoms include constant urge to defecate, anaemia, losing weight without trying and weakness or fatigue with no apparent reasons. It's important to note that most younger people with these symptoms will not have cancer, but it is imperative to get evaluated with these symptoms as the earlier the cancer is found, the more potentially treatable it is.
Usually, CRC affects individuals ≥50 years of age. However, over the past three decades, the incidence among younger people (<50 years) has increased. Between 1990 and 2021, the prevalence of early onset CRC increased from 29.65 to 38.86 per 100,000. The reasons for the increase remain unclear but some potential risks include:
While we still don't know the exact cause of young onset CRC, it is important to recognise the symptoms and be evaluated with any persistent symptoms. Everyone should start colorectal screening at age 45. Those with a family history start earlier so it is important to know if anyone in your family has CRC.
Being diagnosed with CRC at a young age is often a nasty shock, especially for those who maintain a healthy lifestyle. However, undergoing appropriate screenings can help with colorectal cancer prevention and consulting a health care professional with persistent symptoms promptly can help find the cancer at an earlier stage.
This article is authored by Dr Robin Mendelsohn, MD, gastroenterologist, Memorial Sloan Kettering Cancer Center.
