Why is Colorectal Cancer striking at younger ages?

In recent years, colorectal cancer rates in people under the age of 55 have surged. According to the American Cancer Society, the proportion of colorectal cancer occurring in this younger population nearly doubled between 1995 and 2019, going from 11% to 20%. If this trend continues, colorectal cancer is set to become the leading cause of cancer death in younger people in only a matter of years. This is due to the fact that when the cancer is found, it is often at an advanced stage given routine screening is not recommended until age 45.

Screening has led to a steady decline in colorectal cancer rates in older people. While good news, this also points to a key perception that the disease is one that only affects people who are nearing retirement and not still raising children. This may be why digestive symptoms in younger adults can be easily dismissed as nothing to worry about. Another challenge is that symptoms of colorectal cancer, when they do appear (it can be asymptomatic for a long period of time), can seem too embarrassing to discuss either with loved ones or a doctor.

Researchers point to a number of reasons why colorectal cancer may be developing earlier in adulthood. The amount of processed and sugary foods that people consume has greatly increased in recent decades. On top of this, the general population has become less physically active along this same timeline thanks to internet technology and mobile phones.

While it may be challenging to change lifestyle choices around diet and exercise, these are factors that can be modified to lower risk of any cancer developing. However there are factors that cannot be changed. Race for example appears to be a significant factor in the development of colorectal factor. In the US, black men and women are 20% more likely to develop the disease as compared with any other racial or ethnic group. They are more likely to be diagnosed at a younger age, and with advanced illness.

Family history also plays a strong role in the development of colorectal cancer. Someone with a first-degree relative (parent, sibling, child) that has been diagnosed with colorectal cancer has an increased risk of also developing the condition. Even a family history of pre-cancerous polyps increases risk.

Along these lines there are genetic syndromes associated with a predisposition to cancer development. Specifically, a higher risk for colorectal cancer with onset at a younger age. Lynch syndrome, or hereditary non-polyposis colorectal cancer (HNPCC), is the most commonly inherited syndrome that increases the risk of colon cancer. Familial adenomatous polyposis (FAP) and Gardner syndrome are caused by inherited changes in a tumor suppressor gene called APC. Though rare, a mutation to this gene is associated with the development of colon polyps – sometimes hundreds – that have a high risk of turning cancerous given the high number of growths.

Many different public health and media campaigns have been trying to raise awareness of colorectal cancer along with risk factors, symptoms, and the importance of screening. If you have been diagnosed with colorectal cancer and are wondering how you might help raise awareness with friends and loved ones, consider the following:

Sharing your diagnosis story particularly if you had symptoms – what were they and for how long did they present? Was your condition mistaken for something else?

Be open about what it is like to undergo a colonoscopy – what helped with the cleanout process and how did you feel or recover afterwards? If you have been satisfied with your gastroenterologist and the care received, make a referral for those in your life who may feel uncertain about scheduling a colonoscopy.

If you have a history of polyps, have you let any siblings know? This may change the time or frequency at which a sibling undergoes a colonoscopy screening.

As with all medical issues, knowledge is power. With colorectal cancer being diagnosed in younger people, it is important to reduce any stigma or embarrassment associated with digestive signs and symptoms. And though conversations with family members may feel difficult or awkward, they can be vital towards a loved one better understanding their own risk. This may help lead to timelier discussions with healthcare providers around when screening might be advisable to start.