Young-Onset Colorectal Cancer Rates Still Increasing

Rachel Morrell

Overall, colorectal cancer incidence is dropping, but new cases of colon and rectal cancer are occurring at an alarming rate among younger adults in the United States.

According to a study led by the American Cancer Society, Americans born in 1990 “have double the risk of colon cancer and quadruple the risk of rectal cancer compared to people born around 1950.” Researchers examined medical records from almost half a million people aged 20 years or older who were diagnosed with colon or rectal cancer between 1974 and 2013.

For adults between the ages of 20 and 39, colon cancer rates increased by one percent to two percent per year through 2013. In Adults between the ages of 40 and 54, colon cancer rates increased by one-half percent to one percent per year from the mid-1990s through 2013.

Rates of rectal cancer have been increasing even faster, at about three percent per year in adults between the ages of 20 and 39 from 1974 to 2013.

Why Colon and Colorectal Cancer Rates are Rising in Younger People

Why are younger Americans at increased risk for colorectal cancer? Research clearly shows that colorectal cancer incidence has been declining since the mid-1980s, so what’s the problem?

The answer is pretty simple: the problem surrounding young-onset colon cancer is that no one’s looking for it. Here are a few reasons why:

  1. Most people consider colon cancer to be a disease that only affects older people.
  2. Colon cancer often has no noticeable symptoms in the early stages.
  3. The overall wellness of a young person can mask initial symptoms of colon cancer.
  4. Young adults are generally uninformed about warning signs that could indicate the disease.
  5. When symptoms like rectal bleeding, bowel changes, fatigue and anemia appear, young people may dismiss them as hemorrhoids or an infection.

Because of the low index of suspicion, people younger than 55 are 58 percent more likely to be diagnosed with late-stage colorectal cancer than older people and are more likely to die from the disease.

When to get a Colonoscopy or Colon Cancer Screening

We know that colorectal cancer is highly treatable when diagnosed in the early stages, and it is even preventable through routine colonoscopies. So when should adults get their first colon screening? Because 89 percent of colon cancers occur in people who are 50 and older, the current guidelines recommend a baseline colon screening at 50 years of age for men and women who are at average risk for colorectal cancer. But this means 11 percent of colon and rectal cancers are falling under the radar.

While it seems logical that the U.S. Preventative Services Task Force should just lower the colorectal screening age, it is a bit more complicated. The decision involves weighing the potential benefits against the possible risks. At its best, a colonoscopy can prevent cancer or provide early detection of the disease. But lowering screening age also means increased risk for complications like bleeding, infection, adverse reaction to anesthesia, and perforations in the wall of the colon and rectum (American Cancer Society).

Colon Cancer Signs and Symptoms

For now, the current screening recommendations remain unchanged, but this new study is a clear call to action. Colon cancer education is important for all age groups so young people are aware of healthy lifestyle behaviors that can help prevent the disease. Individuals should know their own risk for colorectal cancer and be familiar with the warning signs and symptoms of the disease, including:

  • Rectal bleeding
  • Dark stools
  • Blood in the stool
  • Thin, pencil-like stools
  • Change in bowel habits
  • Chronic diarrhea or constipation
  • Abdominal cramping
  • Weakness and fatigue
  • Full feeling in the abdomen
  • Feeling of incomplete evacuation after a bowel movement
  • Anemia
  • Unexplained weight loss
  • Nausea or vomiting

Connect with a board-certified gastroenterologist at one of our screening centers through our Find a Center tool. Our screening centers offer the same expertise and quality as a hospital in a smaller, more personal environment. Select your state, and a list of our gastroenterology centers will appear at the bottom of the screen. Choose the screening center that is closest to your home and call today to schedule an appointment.

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