Colorectal cancer (CRC) — colon or rectal cancer — rates are down overall, but up sharply for younger people between the ages of 20 to 49, according to a new study published in the Journal of American Medical Association (JAMA) Surgery [1].
“There has been a steady decline in the incidence of CRC in patients age 50 years or older, but the opposite trend has been observed for young adults,” according to authors of the study.
Colorectal cancer ranks third among the most common cancers for women and men. In 2013, there were nearly 143,000 new cases of colorectal cancer and approximately 51,000 deaths in the U.S. linked to the disease, according to the JAMA report. In fact, of all the cancers that equally affect men and women, colorectal cancer is the No. 1 killer, according to federal data.
From 1975 to 2010, colorectal cancer rates dropped by about 1 percent every year overall. But incidences of colon or rectal cancer have increased for younger adults, ages 20 to 49. The study did not identify the reasons for the spike.
“Young adults are not screened for colon cancer. Over time, a greater portion of the colon cancer patients will be younger, especially if the current guidelines continue to be used,” says Eduardo Ruan, M.D. [2], a gastric health specialist affiliated with several Baptist Health hospitals and the Galloway Endoscopy Center [3].
Forecasts for 2030
For young adults, researchers estimate the following spikes in colorectal cancer by 2030:
“At the present rate, the incidence rate for young patients with newly diagnosed colon or rectal cancer will nearly double by 2030, while it will similarly decline by more than one-third among patients older than the screening age of 50 years,” the study says.
Context is important, Dr. Ruan says. The dramatic growth in colorectal cancer rates reflects the relatively lower number of absolute cases in young adults. In absolute terms, the number of colorectal cancer cases in younger adults is far below the number of cases reported for those 50 and older. Still the uptick in cases for young adults is of concern, especially since screening exams have lowered cases of colorectal cancer in older adults.
“A colonoscopy is a tool for prevention,” Dr. Ruan says. “The exam enables your doctor to detect precancerous polyps, which are small growths in the colon. During the exam, the polyps can be removed long before they become cancerous.”
Reducing Risk Factors for Young Adults
More work is needed to identify why rates have spiked for younger adults and what can be done to prevent colorectal cancer in the young, the study says.
In the meantime, young adults can make lifestyle changes historically linked to reduced risks for colorectal cancer, Dr. Ruan says. Healthy habits include:
“Don’t delay seeing your doctor if you have blood in your stool, changes in bowel movements, unexplained weight loss or abnormal blood tests,” Dr. Ruan says.
Screening Guidelines
For most people, the recommended screening age for colorectal cancer is 50, but there are exceptions. If a parent or sibling has been diagnosed with colon or rectal cancer, young adults should get screened earlier.
The recommended formula: Take the age at which your close relative was diagnosed and begin your screening at 10 years younger. Example: If a parent was diagnosed at 50, young adults should get screened for colorectal cancer at 40. And even without a family history of colorectal cancer, African-Americans face a higher risk and should begin screening at age 45, Dr. Ruan says.
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