A Disturbing New Trend

Studies have revealed a rise in colorectal cancer rates among younger adults

The face of colon cancer has changed. When all age groups are combined, the rates of newly diagnosed cases and patient deaths have both dropped. This is likely due to the increased number of patients opting to undergo a screening colonoscopy, in which gastroenterologists can remove pre-cancerous growths called polyps.

Recent studies have uncovered a disturbing trend, however, when looking closer at different age groups. The overall decrease in new cases has been largely seen in adults over the age of 50. Contrarily, for younger adults—even those in their 20’s and 30’s—the numbers paint a different picture.

A Complex Question

“Age is the primary major risk factor for most colon cancers, and it is generally uncommon before the age of 40,” says Travis F. Wiggins, MD, of Gastroenterology Consultants of Savannah. “More recent data however suggest that colon cancer incidence is increasing in the under age 50 group, while it is decreasing in older groups.  In the U.S., the incidence of colon cancer in individuals under the age of 50 steadily increased at a rate of 2 percent annually from 1992 through 2013.”

Mortality rates have also increased among younger white individuals, more closely matching a trend that was previously seen among African-Americans.

“This is a very complex question,” says Brent Acker, MD, of The Center for Digestive & Liver Health. “Historically we have observed higher incidence and mortality rates of colon cancer in African Americans. Recent data have suggested that young white individuals—aged 20 to 54—have seen an increase in colon cancer mortality at the rate of about 1 percent each year.”

Unfortunately, the studies that produced the data did not uncover a clear reason why. Dr. Wiggins notes that only one third of colon cancers diagnosed in individuals under the age of 50 are associated with known hereditary colorectal cancer syndromes.

“Current research available has yet to explain why we are seeing this trend,” Acker says. “We do have very good data, however, to support earlier screening intervals for those with a family history of colon cancer.”

What You Can Do

Having knowledge of a family history, and bringing that to your doctor’s attention, is an important step in prevention or early detection of colorectal cancer.

“Especially if your family member was affected under the age of 60,” Wiggins says.

Awareness and management of modifiable risk factors is also essential to both reducing cancer risk and improving overall health. Both Dr. Wiggins and Dr. Acker recommend:

• Regular exercise
• Balanced diet (high in fruit, vegetables, whole grains—low in red, processed meats and saturated fat)
• Minimizing alcohol consumption and quitting smoking

Both physicians also emphasize how crucial it is to recognize and address symptoms.

“Persistent rectal bleeding at any age, unexplained weight loss, or progressively worsening abdominal pain should prompt a medical evaluation,” Wiggins says.

“Never ignore symptoms,” Acker adds. “Rectal bleeding is always abnormal and one should never assume it is ‘just hemorrhoids’ at any age.”

With some millennials now shown to be at risk for colorectal cancer, it’s clear that paying attention to risk factors and symptoms of the disease is no longer just an older person’s responsibility.

Screening Fears

Though screenings for colorectal cancer have increased among the older generation, gastroenterologists still encounter patients with fears about the procedure.  While these concerns are understandable, some are unfounded, including:

• “The prep is unbearable.” There are actually low-volume and split dose options for patients who can’t handle a large volume of bowel preparation liquid at one time. Talk with your doctor about the best way to make this crucial step manageable.
• “It will be painful.” Actually, most people sleep right through the procedure and wake with no memory of it. Experienced anesthesiologists create what is called a conscious sedation for the patient, helping them to be comfortable and stress-free throughout the procedure.
• “My colon could get injured.” Colonoscopies performed by specially-trained gastroenterologists like Dr. Acker and Dr. Wiggins are actually quite safe, with a very low risk of colon perforation or bleeding.
• “It’s embarrassingly invasive.” Gastroenterologists understand the sensitive nature of a colonoscopy and do everything in their power to make it a respectful, private experience. Remember, they actually do thousands of these screenings a year, and their only focus is on how the screening can possibly save your life.