Dr. Kimmie Ng, a leading gastrointestinal oncologist and founding director of the Young-Onset Colorectal Cancer Center at Dana-Farber Cancer Institute, shared her growing concern. She told CNN's Dr. Sanjay Gupta that it was "shocking" to initially see fit, healthy young people with no risk factors diagnosed with Stage 4 disease, but the cases have become increasingly common.
Since the mid-1990s, the incidence of both colon and rectal cancer has been increasing by about 2% per year in younger individuals, a trend seen in both men and women across the US and worldwide.
The Unique Burden on Young Adults
Younger patients face distinct challenges that complicate their cancer journey:
- Family & Career: About 80% have children under 18, are actively caring for elderly parents, and are in the prime of their careers or continuing their education.
- Mortality: Early-onset colorectal cancer is already the leading cause of cancer-related death for men under 50 in the US. If the trend continues, it is projected to become the leading cause for women under 50 by 2030 (it is currently second after breast cancer).
Dr. Ng emphasizes that, in absolute terms, early-onset cases are still relatively rare. Moreover, across all age groups, colorectal cancer incidence and death rates have been declining for decades, thanks to improved screening and treatment—a benefit, however, that has not been seen in the under-50 population.
Red Flags: Know the Symptoms
Early detection is vital, making awareness of symptoms essential:
- Blood in Stool: The most common red flag in young people. Look for blood that is mixed into the stool itself, which is often more characteristic of a malignant cause than blood simply on the surface or toilet paper.
- Unintentional Weight Loss.
- Prolonged Changes in Bowel Habits: This includes new or persistent diarrhea, constipation, or stools that appear thinner than usual.
- Abdominal Pain and Fatigue (which may indicate anemia).
Dr. Ng stressed the importance of normalizing these uncomfortable conversations, urging people to discuss any change in bowel habits with their doctor, even if the doctor doesn't prompt them.
Searching for the Cause: Environmental Factors
Researchers believe the rise is linked to recent environmental exposures, as genes couldn't change rapidly enough to be the primary culprit. This rise is generational; an individual born in 1990 has more than four times the risk of developing rectal cancer and more than twice the risk of colon cancer compared to someone born in 1950.
Leading hypotheses for the drivers include:
- Diet and Lifestyle: Obesity, sedentary behavior, and diets high in red meat, processed foods, and sugar-sweetened beverages. Obesity increases body-wide inflammation, which is linked to cancer development.
- The Paradox: However, Dr. Ng notes that many of the young patients she treats are not obese; some are triathletes who eat very healthy diets.
- Other Exposures: The influence of other factors, such as microplastics and the impact of toxins and diet in early life on the microbiome, are still being studied.
Call to Action: Screening and Testing
While the recommended age for average-risk colorectal cancer screening was lowered from 50 to 45 in 2021, Dr. Ng stresses that the primary focus should be on:
- Pinpointing Risk Factors: Research is needed to identify why this surge is happening so doctors can tailor earlier screening recommendations for high-risk individuals, like an asymptomatic 30-year-old.
- Increased Screening Adherence: Public health efforts must continue to advocate for screening, as it is "lifesaving."
- Genetic Testing: All young patients diagnosed with cancer should undergo familial genetic testing (for syndromes like Lynch syndrome), as this is more likely to be a factor in early-onset cases.
Dr. Ng also highlighted a sobering fact: while younger patients are often healthier and can tolerate aggressive treatment better, their overall survival rates are not necessarily better than older patients, and those under age 35 often have shorter survival. This underscores the urgency of early detection through awareness and appropriate screening.
Disclaimer: This content is published only for health awareness and informational purposes. It's not a substitute for your professional medical advice. You must consult a doctor/healthcare professional regarding your specific health concerns.
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