Roundup: Sharp Rise in Colorectal Cancers in Young Adults May Spur New Screening Guidelines

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March 3, 2017


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Most colorectal cancers are still diagnosed in people older than 50, but a surprising new report finds that young people have double the risk of colon cancer and quadruple the risk of rectal cancer — compared with baby boomers (the generation born between 1946 and 1964).

The new finding raises questions as to whether lifestyle factors — including the prevalence of obesity tied to poor diets and lack of regular exercise — can help explain the sharp increases in colorectal cancers among young people. The report may also result in expanded screening guidelines for adults younger than 50.

The American Cancer Society researchers reviewed the records of almost 500,000 people 20 years and older who were diagnosed with colon or rectal cancer from 1974 through 2013. The data came from the Surveillance, Epidemiology, and End Results (SEER) program, which houses registries of people diagnosed with cancer. They included people born in 1890 through those born in 1990.

Adults Ages 20 to 39 See Higher Rate Increases
For adults ages 20 to 39, colon cancer rates increased by 1 percent to 2 percent per year through 2013, the study found. In adults 40 to 54, rates increased by 0.5 percent to 1 percent per year from the mid-1990s through 2013.

Rates of rectal cancer have increased at an even higher rates and over longer periods of time, compared to colon cancer. Rectal cancer rates jumped about 3 percent per year from 1974 to 2013 in adults ages 20 to 29, and from 1980 to 2013 in adults ages 30 to 39. In adults ages 40 to 54, rectal cancer rates increased by 2 percent per year from the 1990s to 2013.

Researchers also found that people younger than 55 are 58 percent more likely to be diagnosed with late-stage colorectal cancers, compared to older people. The authors say this is “largely due to delayed follow-up of symptoms, sometimes for years, because cancer is typically not on the radar of young adults or their providers.”

More ‘Educational Campaigns’ Needed
Because of the success of promoting the importance of colorectal cancer screenings, colon and rectal cancer rates among older adults have been decreasing for years. In adults 55 and older, colon cancer rates have been falling since the mid-1980s. For rectal cancer, rates have been falling since 1974. Screenings can range from yearly stool tests to a once-a-decade colonoscopy, in which a doctor examines the inside of the colon.

“Educational campaigns are needed to alert clinicians and the general public about this increase to help reduce delays in diagnosis, which are so prevalent in young people, but also to encourage healthier eating and more active lifestyles to try to reverse this trend,” said Rebecca Siegel, an epidemiologist at the American Cancer Society and the lead author of the study, in a statement.

Currently, the American Cancer Society recommends testing for colorectal cancer start at age 50 for most people, with screening starting at a younger age for those with a family history of colon or rectal cancer. However, the study’s authors propose that screenings be considered before age 50 in light of the findings rates among younger people are sharply increasing.

“This new data will be examined by our independent guidelines development group to review whether a change in our screening recommendations is warranted,” said Otis Brawley, M.D., chief medical officer for the American Cancer Society.

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Female Athletes More Likely to Suffer Concussions, Study Says

Female athletes seem to be more likely than men to suffer concussions during their careers on the field, a new study says.

The findings bolster established evidence that female athletes may be more susceptible to concussions, although most studies focus on male athletes from youth and school leagues to the professional levels.

“The more we look at concussion, the more we realize that women are at high risk,” said study co-author Dr. James Noble, assistant professor of neurology at Columbia University Medical Center in New York City.

In the latest study, researchers monitored more than 1,200 athletes from Columbia University from 2000 to 2014. More than 800 were male, and almost 400 were female. The athletes all played sports associated with a higher risk of concussions. For women, these sports included field hockey, soccer, basketball, softball and lacrosse.

Twenty-three percent of the women and 17 percent of the men had at least one concussion during their college careers over the time of the study.

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