Courtesy of Roswell Park Comprehensive Cancer Center; adapted with permission from Roswell Park’s Cancer Talk blog

While colon and rectal cancer mostly affects people over age 50, incidence has been increasing dramatically among younger adults.

It’s important for adults of every age to get any symptoms or unexpected changes checked out, and to be aware of some key facts about colorectal cancer — especially about opportunities for early detection and intervention.

1. Under age 50? You’re not too young for colorectal cancer.

While 90% of colorectal cancer diagnoses occur in those ages 50 and older, colorectal cancer is increasing among young people under 50. The rise is significant, and national guidelines now recommend colorectal screening begin by age 45 for those at average risk; younger if you have a family history or other risk factors. Unfortunately, because these “young onset” cancers are usually discovered at a later stage, colorectal cancer deaths among younger people are also rising.

2. Colorectal cancer among younger people will continue to rise.

Studies estimate that by 2030, colon cancer rates in people ages 20 to 34 will increase by 90% and rectal cancer rates will rise by more than 124%. The reason is unclear, says medical oncologist Deepak Vadehra, DO, who specializes in treating young adult patients with colorectal cancer at Roswell Park — and focuses on trends and experiences among young patients in his research.

“There are a lot of interesting theories, and it’s likely a combination of factors, including diet, especially diets high in red meat and processed foods, sedentary lifestyles, differences in metabolism and gut microbiome,” Dr. Vadehra says. “Younger people with colorectal cancer have a different gut microbiome.”

3. Know the symptoms; don’t ignore them.

Pay attention to changes in your body that may be a symptom of colorectal cancer. They include blood in your stool, or bleeding from your bottom; changes in bowel habits, such as diarrhea or constipation; changes in composition of your stool (for example, pencil-thin); unexplained weight loss; unexplained anemia; dark, black-colored stool; abdominal discomfort, such as pain or cramping; a lump in your abdomen; the sensation you need to have a bowel movement even after you’ve had one; weakness or feeling tired. If a symptom persists for more than a few weeks, it’s time to get checked out.

“The most common thing I hear from younger patients is they thought the bleeding was due to hemorrhoids, and that’s what delayed their diagnosis,” says Dr. Vadehra. “You don’t want to guess that it’s hemorrhoids, you need to know for sure — and that takes a colonoscopy, a flexible sigmoidoscopy, or at the very least an exam by a gastrointestinal specialist.”

4. You need to know your family history.

Having a first-degree relative (parent, sibling, child) with colon or rectal cancer significantly increases your risk of developing the disease — and it means you should begin screening 10 years earlier than the age they were diagnosed. If a family member was diagnosed at age 50, you need to start by age 40, and possibly younger. Other risk factors include a personal history of colorectal polyps, Crohn’s disease, ulcerative colitis, Lynch syndrome, and other genetic mutations.

5. Healthy eating and behaviors matter.

Maintaining a healthy weight through exercise and a balanced diet is key. Focus on whole grains, high-fiber foods, fruits and vegetables. Limit your red meat intake and alcohol consumption. And, of course, don’t smoke or use any form of tobacco.

Resources

*Visit https://forms.roswellpark.org/screening-prevention for a special colon cancer screening assessment.

*Learn more about Dr. Vadehra and his team, and Roswell Park’s Young Onset Colorectal Cancer Program at https://roswellpark.org/cancer/colorectal/young-onset-colorectal-cancer.

*Visit www.roswellpark.org/cancertalk/202303/stage-3-colorectal-cancer-mikes-story to read about Roswell Park patient Mike Garvey, who was just 44 when he was screened, diagnosed, and successfully treated for colon cancer.