Colorectal cancer is rising in younger adults. Here’s who is most at risk and symptoms to watch for
Colorectal cancer, long considered a disease of older adults, is increasingly affecting younger men, and women. It is now the leading cause of cancer death for Americans under 50.
A Rising Threat to Younger Adults
The recent deaths of actor James Van Der Beek, at age 48, and Chadwick Boseman, at 43 in 2020, underscore the growing risk faced by younger adults. Dr. John Marshall of Georgetown University’s Lombardi Comprehensive Cancer Center, a cancer doctor for over three decades, notes a stark change in his practice. “We’re now starting to see more and more people in the 20-, 30- and 40-year-old range developing colon cancer. At the beginning of my career, nobody that age had colorectal cancer,” he said.
Understanding the Scope of the Problem
While colorectal cancer remains the nation’s second leading cancer killer overall—behind lung cancer, which is expected to claim over 55,000 lives this year—the trend among younger adults is particularly concerning. Although overall cases and deaths have slightly decreased in recent years due to early detection through screening, mortality rates for those under 50 have been rising since 2005, increasing by 1.1% annually.
Who is at Risk?
The majority of colorectal cancer cases and deaths still occur in individuals 50 and older, and this age group has seen a 1.5% annual decrease in deaths over the past decade. However, diagnoses are increasing in those under 50. Risk factors include obesity, lack of physical activity, a diet high in red or processed meat and low in fruits and vegetables, smoking, heavy alcohol use, inflammatory bowel disease, and a family history of the disease.
Recognizing the Symptoms
Symptoms of colorectal cancer include blood in stool or rectal bleeding, changes in bowel habits like diarrhea or constipation, narrowing of stool, unintended weight loss, and abdominal cramps or pain. Dr. Marshall emphasizes the importance of seeking medical attention if these symptoms arise, stating, “Don’t ignore symptoms. Get it checked.” Early diagnosis significantly improves survival rates.
Screening and Prevention
Current medical guidelines recommend that average-risk individuals begin screening at age 45. However, this may be too late for some. Individuals with higher risk factors should discuss earlier screening with their doctors. Screening options include yearly stool-based tests and colonoscopies, which may be performed every 10 years if no issues are found. A newer blood test is also available for adults 45 and older.
The Unknown Cause
The reasons behind the rise in colorectal cancer among younger adults remain unclear. Dr. Marshall notes that many young patients do not present with typical risk factors, leading researchers to explore potential roles for changes in gut bacteria—the microbiome. Differences in tumor location within the colon between younger and older patients are also being investigated.
Frequently Asked Questions
What are the symptoms of colorectal cancer?
Symptoms include blood in stool or rectal bleeding; changes in bowel habits such as diarrhea, constipation or narrowing of stool that lasts more than a few days; unintended weight loss; and cramps or abdominal pain.
At what age should I start getting screened?
Medical guidelines say the average person should start getting screened at age 45, but people known to be at higher risk are supposed to talk with their doctors about whether to start screening even earlier.
Is there a link between diet and colorectal cancer?
Risk factors include a diet high in red or processed meat and low in fruits and vegetables. Dr. Marshall advises everyone to eat lots of fruits and vegetables and whole grains, and to eat less meat.
As research continues, will we see a shift in screening recommendations to better protect younger generations from this increasingly prevalent disease?