Colorectal cancer rates rising for younger Americans

While the rate of colorectal cancer is declining in those over 65, the astonishing news is that the number of cases is increasing at an alarming rate for Generation Z, Millennials, and Generation X people. These are young adults in their mid-20s to late 50s. And researchers are perplexed as to why.

The American Cancer Society’s 2023 report, containing the latest data, tells us that colorectal cancer cases have increased from 11 percent in 1995 to 20 percent in 2019 in adults younger than 55 years old. Thanks to these statistics the ACS lowered the age for recommended colorectal cancer screening from age 50 to 45. 

I found a story on the UCLA Health’s website about a man who was only 26 years old who had extreme stomach pains which he thought was just the flu. After the symptoms didn’t subside with medications, he saw a gastroenterologist who ordered a colonoscopy. Unheard of for a man that young, but sure enough, it was a malignant tumor in his rectum. 

The American College of Surgeons website says that clinicians, for the most part, have believed that diet and lifestyle are suspected to be driving factors for this increase in colorectal cancer but that’s not always the case. 

“For early onset colorectal cancer, a troubling conundrum for clinicians is tethered to the question of ‘why?’ because some of these young patients present as healthy individuals with no family history of the disease, engaging in regular exercise and consuming a healthy diet. In fact, many of the patients are not obese, which is long considered a primary risk factor for colorectal cancer among adults younger than 55,” their website says. 

A 2024 scientific review published in the Journal of the American Medical Association concluded that the common warning symptoms for colorectal cancer are abdominal pain, anemia, and altered bowel habits. These are the red flags that everyone should be aware of. 

Sonia Ramamoorthy, MD, FACS, chief of colorectal surgery at the University of California San Diego said, “If you’re 39 and you’re having these symptoms, you’re not thinking, ‘I have colon cancer,’ you’re thinking ‘I ate something,’ ‘I’m working too hard.’ If you’re tired and you’re stressed out, you’re thinking, ‘it’ll go away.’” 

We’ll pause here to tell you to call your primary care provider right away if you experience any of these symptoms. Get in, get tested. Just so you know, the reason fewer people over 65 are being diagnosed with colorectal cancer is because they are the ones getting colonoscopies. And when the screening presents polyps, they’re removed before they become cancerous. Got it? 

“My personal bias is that we could probably drop the screening age another five years – to age 40,” Dr. Ramamoorthy said. “I really think we would capture a lot of what we’re currently seeing as early onset colorectal cancers.” 

Although colonoscopy is the gold standard, there are other tests your PCP might encourage you to have. But bear in mind, if any of the other tests show suspicious signs of cancer, you’ll probably end up having a colonoscopy, anyway. 

ACA tells us that the FDA has approved two blood tests for people who are at average risk. “These tests look for possible signs of colorectal cancer or pre-cancerous polyps in a person’s blood, although they are more accurate at detecting colorectal cancer than pre-cancerous polyps.” 

Stool-based tests look at the stool (feces) for possible signs of cancer or polyps, such as small amounts of blood or changes in the DNA or RNA from cells in the stool. With these tests you collect the samples in the privacy of your own bathroom. 

How does it work? “Blood vessels in larger colorectal polyps or in cancers are often fragile and easily damaged when stool passes through. The damaged vessels usually bleed into the colon or rectum, but only rarely is there enough blood for it to be seen by the naked eye in the stool,” ACA explains. 

You can inherit the tendency toward colorectal cancer and those with inflammatory bowel diseases are at higher risk. It’s also important to know that lifestyle risks such as being obese, having diabetes, smoking, alcohol usage and diets consisting of red and processed meats can also be a factor. But in other cases? Who knows? 

Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com.