Column: It’s no myth, colorectal cancer is increasing among younger adults

Colorectal cancer, a broad term ascribed to cancer of the colon or rectum, is the third most common form of cancer diagnosed in the U.S. The American Cancer Society estimates that 150,000 Americans – one in every 21 men and one in every 23 women – will be diagnosed this year. While it is more prevalent among seniors, since the mid-1980s, the rate has consistently risen among younger adults.

About 12% of all colorectal cancer cases will occur in individuals under 50, making it crucial to dispel myths associated with the disease as it pertains to a younger population.

Myth: Younger adults are not at risk for developing colorectal cancer

From 2012 to 2016, new cases of colorectal cancer increased 2.2% a year for Americans younger than 50, and has become the leading cause of cancer deaths for Americans ages 20 to 49, according to the National Cancer Institute. While a specific cause has not been linked, our partner, the Colorectal Cancer Alliance, is driving awareness, education, advocacy and research funding.

In response, in May 2021, the U.S. Preventive Services Taskforce, an independent panel of top primary care and prevention experts, lowered its recommended age for colorectal cancer screening from 50 to 45.

As a health care and oncology community, we are calling on younger adults to understand their risks, pay attention to their bodies and get screened as appropriate.

Myth: Only people who are at high risk for developing colorectal cancer should receive regular screenings

Screening is one of the most significant ways to combat colorectal cancer in younger and middle-aged adults and increases a person’s chances of survival. Those diagnosed have a 90 percent five-year survival rate when colorectal cancer is detected early and treated appropriately.

While there are various methods, the “gold standard” continues to be a colonoscopy, specifically an optical colonoscopy. This allows health care professionals to view the entire colon and both detect and remove polyps in the same procedure. Removing polyps before they turn into cancer is not possible through other screening methods, such as a stool DNA test or imaging. These tests also must be performed more frequently and can miss polyps that would otherwise be identified during a colonoscopy.

Younger adults with a family or personal history of colorectal cancer or certain types of polyps, hereditary factors such as familial adenomatous polyposis of Lynch syndrome or inflammatory bowel disease are at a higher risk of developing colorectal cancer and should talk to their doctors about screenings regardless of age.

Most health insurance plans cover the costs of colorectal cancer screenings.

Myth: There are no means to help prevent colorectal cancer

Though family and some personal health factors are beyond control in limiting the risk of colorectal cancer, active measures can be taken to help prevent the disease, including maintaining a healthy weight.

Obesity greatly increases the risk of colorectal cancer, especially in men.

Effective daily precautions for preventing colorectal cancer can include limiting intake of red meats and processed meats, restricting alcohol consumption and avoiding smoking.

While we know regular screenings are key to prevention, unfortunately, the COVID-19 pandemic led to a rapid decline in colorectal cancer screenings, up to 79% during the early stages of the pandemic, according to a Journal of the American Medical Association study.

Pandemic or not, it is essential for people to continue regular checkups and necessary screenings.

Key takeaways

Be proactive. Talk with your physician about a proactive plan to promote good colorectal health, know your risk factors and receive colorectal screenings as appropriate.

Don’t ignore red flags. These include but are not limited to a change in bowel habits, the feeling your bowels don’t completely empty, blood in the stool, unexplained weight loss or loss of appetite.

If diagnosed, seek specialized care. For those diagnosed with colorectal cancer, there is reason for hope. Learn about your options and advances in treatments such as surgery, chemotherapy, radiation and monoclonal antibody therapies.

Pankaj Vashi, MD, AGAF, FASPEN, has been with Cancer Treatment Centers of America Chicago since 1992. He is the vice chief of staff and medical director of gastroenterology/nutrition and metabolic support.