Colorectal cancer generally is not viewed as a disease of younger people. However, over the last 20-some years, colorectal cancer rates in people ages 20 to 49 have increased significantly. This uptick is expected to continue over the next two decades. Researchers are trying to understand why.
Experts don’t have any definitive data that shows what is causing this increase. Some experts propose rising obesity rates or other dietary changes may provide an explanation. But they have yet to identify a clear link, especially when it comes to cancers in very young people.
“We know that certain diets and environments may increase the risk for colorectal cancer in older adults. This may play a role in younger people too, as our diets are constantly changing and evolving from generation to generation,” says colorectal surgeon Matthew Kalady, MD.
Even though the causes for the increase in cases are still unclear, Dr. Kalady says young adults can protect themselves with these five tips:
Young adults have heard over and over again that colorectal cancer is a disease of the old, causing them to ignore symptoms.
“We see a number of young patients who may have initially ignored symptoms or were told they were ‘too young’ to have colorectal cancer,” Dr. Kalady says. “Many of the advanced cases of colorectal cancer are young people who have been misdiagnosed or had a delayed evaluation because people commonly view this as a cancer of older adults.”
Not everyone with colorectal cancer experiences the same symptoms. Some develop anemia, which is a low red blood cell count. Others may see blood mixed with bowel movements. Patients may also report belly pain or symptoms of blockage, but Dr. Kalady says that these are often, but not always, more advanced cases.
Many patients with colorectal cancer may not have any symptoms in the early stages, when it’s easier to treat. This makes risk assessment critical for identifying those with a higher risk of developing the disease. Primary care physicians can help assess your risk, and there are online tools available as well.
“I encourage patients of all ages to know their family history. It’s extremely important that everyone know if a close relative was ever treated for colorectal cancer or colon polyps,” Dr. Kalady says.
Fresh fruits and vegetables and other high-fiber foods, as well as regular exercise, help keep the colon healthy. While experts still have much to learn about how lifestyle affects colorectal risk, Dr. Kalady also suggests young people reduce consumption of red meats and over-processed foods. Also, if they smoke, he suggests that they quit.
Everyone, even the very young, should take their health seriously and develop a good relationship with a primary care physician. This makes it easier to feel comfortable reporting any unusual or worrisome symptoms. “Don’t just assume you have hemorrhoids if you see blood on the toilet paper or in the toilet. Tell your physician so he or she can assess you immediately,” Dr. Kalady says.
The overall incidence of colorectal cancer has decreased in people older than age 50. Experts largely attribute this decrease to regular colonoscopy screenings. These screenings aren’t currently recommended for younger people, but some believe the guidelines need to be updated to address the current trend of increased colon cancer in younger people.
“It’s imperative to continually change our guidelines for colorectal cancer screening as we learn more about it. We must always balance our desire to screen patients with the risk of complications and cost,” Dr. Kalady says.
Colonoscopy is a very safe procedure. Only time will tell if these preventive measures will become routine for younger adults.
As scientists learn more about the specific biology of colorectal cancer, they will develop new ways to treat the disease in each individual patient, regardless of age, Dr. Kalady says.
“We’re learning so much each day,” Dr. Kalady says. “It could be the colorectal cancer that develops in younger people has a different biology or behavior pathway than that in older adults.”