Previously, colorectal cancer was associated mainly with the older generation; but recently there has been an increase in diagnoses and deaths among younger adults, ranging from their mid-20s to late 50s, and alarming the medical fraternity, which is urging more people to be screened.
In fact, says the US National Cancer Institute, the rate of colorectal cancer in adults under 50 has doubled since the 1990s. The most recent data, which tracked the incidence of colorectal cancer from 2011 to 2016, revealed an up to 2% annual increase in this age grouping.
It’s the third most commonly diagnosed cancer and the third most common cause of cancer‐related death in both men and women in the US, ranking second in cancer‐related deaths globally and now the leading cause of cancer deaths in men under 50.
It is estimated that by 2030, one in 10 colon cancers and one in four rectal cancers will be diagnosed in people under 50-years-old.
These data prompted the United States Preventative Task Force (USPTF) and American Cancer Society to update their screening recommendations, in 2021, to age 45, rather than 50, reports Axios Health.
“We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population,” said Rebecca Siegel, senior scientific director, surveillance research at the American Cancer Society, and lead author of a recent report in CA: A Cancer Journal for Clinicians.
She said the latest findings confirm trends observed in previous studies and have major implications for convincing younger people to get screened for the disease.
Howard Hochster, director of the Gastrointestinal Oncology Programme and associate director for Clinical Research at Rutgers Cancer Institute of New Jersey, and director of Oncology Research, RWJBarnabas Health, said the exact factors driving this rise in colorectal cancers in young patients remained unclear.
“Research suggests that lifestyle factors like poor diet, obesity and heavy alcohol use can contribute to the onset, but none has been identified as the exact cause of this recent trend, and gene sequencing of tumours across age groups has not shown major differences.”
For young people, staying aware can be lifesaving
He said younger people might not seek colon cancer screening with their first symptom “because of a misconception that it’s an unlikely diagnosis”, reports New Medical Life Science Journal.
“This can delay diagnosis, giving the cancer time to progress to a later stage. Earlier screenings along with recognising the symptoms and taking them seriously may help curb this trend. Eating a balanced low-fat diet high in fruits and vegetables, reducing alcohol consumption, preventing or stopping tobacco use, and increasing physical activity can also help reduce the risk of colorectal cancer as well as other cancer types.”
Study details
Colorectal cancer statistics, 2023
Rebecca Siegel, Nikita Sandeep Wagle, Andrea Cercek, Robert Smith, Ahmedin Jemal.
Published in A Cancer Journal for Clinicians on 1 March 2023
Abstract
Colorectal cancer (CRC) is the second most common cause of cancer death in the United States. Every three years, the American Cancer Society provides an update of CRC statistics based on incidence from population-based cancer registries and mortality from the National Center for Health Statistics. In 2023, approximately 153 020 individuals will be diagnosed with CRC and 52 550 will die from the disease, including 19 550 cases and 3 750 deaths in individuals younger than 50 years. The decline in CRC incidence slowed from 3%–4% annually during the 2000s to 1% annually during 2011–2019, driven partly by an increase in individuals younger than 55 years of 1%–2% annually since the mid-1990s. Consequently, the proportion of cases among those younger than 55 years increased from 11% in 1995 to 20% in 2019. Incidence since circa 2010 increased in those younger than 65 years for regional-stage disease by about 2%–3% annually and for distant-stage disease by 0.5%–3% annually, reversing the overall shift to earlier stage diagnosis that occurred during 1995 through 2005. For example, 60% of all new cases were advanced in 2019 versus 52% in the mid-2000s and 57% in 1995, before widespread screening. There is also a shift to left-sided tumors, with the proportion of rectal cancer increasing from 27% in 1995 to 31% in 2019. CRC mortality declined by 2% annually from 2011–2020 overall but increased by 0.5%–3% annually in individuals younger than 50 years and in Native Americans younger than 65 years.
Summary
Despite continued overall declines, CRC is rapidly shifting to diagnosis at a younger age, at a more advanced stage, and in the left colon/rectum. Progress against CRC could be accelerated by uncovering the etiology of rising incidence in generations born since 1950 and increasing access to high-quality screening and treatment among all populations, especially Native Americans.
Cancer Journal for Clinicians article – Colorectal cancer statistics, 2023 (Open access)
Axios article – Colorectal cancer getting diagnosed later, among younger people: study (Open access)
See more from MedicalBrief archives:
US studies show colorectal cancer link to ultra-processed foods
Antibiotic use linked to increased risk of colon cancer — Swedish Colorectal Cancer Registry
Vitamin D deficiency from inadequate sunlight may increase colorectal cancer risk
Colorectal cancer prevention: BMJ evidence review of 80 meta-analyses