Rising Colon Cancer Rates in Young Adults: Reduce Your Risk
The Changing Face of Colorectal Cancer
Dr. Bethany Malone has treated numerous patients with colorectal cancer, and the youngest among them, excluding those with genetic conditions, was just 19 years old. This is a stark contrast to the past when colorectal cancer was typically associated with older adults. While patients in their teens and early 20s are still not the norm, they are becoming increasingly common.
“I have not gone a year in practice without taking a colon cancer out of someone in their 20s,” Malone said. As a colon and rectal surgeon and associate program director for the general surgery residency at Texas Health Harris Methodist Hospital Fort Worth, her experience in North Texas reflects a global trend. Colorectal cancer, which includes cancer of the colon and rectum, is considered early onset when diagnosed in individuals under the age of 50. Although the majority of cases still occur in people aged 65 or older, the rates of early onset have been rising worldwide, particularly in high-income countries.
In a 2023 report, the American Cancer Society noted that the trends of decreasing incidence in older people and increasing incidence in younger people are “rapidly shifting the patient population younger.” High-profile cases, such as the death of Black Panther actor Chadwick Boseman from colon cancer at age 43 and the passing of former Dallas Cowboys Cheerleaders choreographer Criscilla Anderson at age 45, highlight this concerning shift. Locally, Dallas musician Joshua Ray Walker was diagnosed with colon cancer in late 2023 at age 33, and he later announced he was cancer-free after treatment and surgery.
Why Are Rates Rising?
Medical experts suggest that there isn’t a single cause for the increase in colorectal cancer among younger people. However, several contributing factors have been identified. Dr. Radhika Kainthla, a medical oncologist at Parkland Memorial Hospital in Dallas, noted that about 20% of early onset cases have a genetic component, meaning 80% do not. “There’s a misconception that if it’s a young person being diagnosed with cancer, it must be genetic,” Kainthla said. “But that’s not actually what we’re seeing.”
Instead, experts point to a combination of environmental and lifestyle factors. These include diets high in red meat, ultra-processed foods, and a lack of regular exercise. Dr. Malone emphasized the importance of fiber intake, noting that Americans tend to consume low amounts of fiber, which can increase the risk of colorectal cancer. Fiber helps maintain a healthy gut microbiome and flushes carcinogens out of the body before they are absorbed.
Dr. Emina Huang, a professor of surgery at UT Southwestern Medical Center, added that environmental factors also play a role. For example, living near a superfund site, which are hazardous waste sites, has been linked to an increased risk of cancer.
Reducing Your Risk
The three experts agree that reducing the risk of colorectal cancer involves many of the same health recommendations that apply to general well-being. They advise focusing on regular exercise, avoiding smoking, moderating alcohol consumption, and eating a diet rich in fruits, vegetables, and fiber while low in red meat. Obesity is also a risk factor, though Malone cautioned against focusing solely on weight loss. Restrictive diets may lead to lower fiber intake, which can be harmful rather than helpful.
Patients should also pay attention to their bodies and seek medical care if they notice symptoms such as abdominal pain or changes in bowel movements.
When to Start Screening
Because of the rising rates of colorectal cancer among younger people, the U.S. Preventive Services Task Force recommends regular screenings beginning at age 45. The gold standard for screening is a colonoscopy, but stool tests and scans can also be used.
For individuals with a standard risk profile, the 45-year-old recommendation applies. However, those at higher risk due to personal or family history may need to start earlier. People with a first-degree relative (sibling, parent, or child) diagnosed with colorectal cancer or polyps should begin screenings 10 years before the age at which their relative was diagnosed. For instance, if a father was diagnosed at 48, the individual should start at 38. Patients with such a family history should begin screenings no later than age 40.
Individuals with personal histories of Crohn’s disease or ulcerative colitis are also at higher risk and should start screenings earlier. Kainthla also mentioned that other screening options, such as blood tests and stool tests, may be suitable for some patients.
Recognizing the Warning Signs
Medical experts emphasize that for most young people, gastrointestinal symptoms are unlikely to indicate colorectal cancer. However, certain signs should serve as red flags. The most common early symptoms include persistent stomach pain, changes in bowel movements that do not improve, and blood in the stool. These symptoms can sometimes indicate more benign conditions like hemorrhoids, but if they persist despite treatment, it may signal something more serious.
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