COLON AND RECTAL CANCER IS ON THE RISE among those in their early 50s or younger. One in five new cases of colorectal cancer occurs in younger individuals, according to a new report from the American Cancer Society. Today, we look at the troubling rise in colorectal cancer among young adults.
The report offers that the proportion of colon and rectal cases among adults under 55 increased from 11 percent in 1995 to 20 percent in 2019. Moreover, the stage at diagnosis is shifting: There are more diagnoses of advanced stages of cancer among members of all age groups.
Today we explore colorectal cancer basics before turning to the disturbing rise in colorectal cancer incidence among young persons.
“Absence is a house so vast that inside you will pass through its walls and hang pictures on the air.” ― Pablo Neruda.
Colorectal cancer basics
Colorectal cancer, also known as bowel cancer, is a type of cancer that develops in the colon or rectum. The colon is the large intestine, and the rectum is the last part of the large intestine that leads to the anus. Colorectal cancer usually begins as a growth called a polyp on the inner lining of the colon or rectum, which can become cancerous over time.
Symptoms of colorectal cancer may include blood in the stool, changes in bowel habits, abdominal pain or cramping, unexplained weight loss, and fatigue. However, some people with colorectal cancer may not experience symptoms, so regular screenings are important for early detection.
Treatment for colorectal cancer may include surgery, radiation therapy, chemotherapy, or a combination of these. The type of treatment recommended will depend on the stage and location of cancer and the individual’s overall health. With early detection and proper treatment, the prognosis for colorectal cancer can be good.
More colorectal cancer cures
The new American Cancer Society report highlights improving survival statistics:
The colorectal cancer relative survival rate (at least five years after diagnosis) has risen from 50 percent in the mid-1970s to 65 percent from 2012 through 2018. This improvement is partially secondary to better treatment.
Overall trends suggest colon and rectal cancer incidence and death rates are slowly declining. In the report, colon cancer incidence dropped from 66 per 100,000 in 1985 to 35 per 100,000 in 2019. Incidence has dropped nearly in half.
Colorectal cancer mortality rates are improving.
The colorectal cancer mortality declines are even more striking. The colorectal cancer death rates were 29.2 per 100,000 in 1970. This rate contrasted with 12.6 per 100,000 in 2020. The death rate has dropped by more than half (55 percent).
Troubling Colorectal Cancer Rise in Young Adults
The long-term decline in colorectal cancer incidence rates slowed from four to three percent annually during the 2000s to nearly one percent annually from 2011 through 2019. This slowing drop is due, at least in part, to a rise in cases among young individuals.
The proportion of colorectal cancer cases among those under 55 increased from 11 percent in 1995 to 20 percent in 2019. More disturbingly, while overall colorectal cancer mortality declined by two percent annually from 2011 to 2020, death rates increased by 0.5 to 3 percent annually in those under 65.
Colorectal cancer is rapidly shifting to a diagnosis at a younger age, cancer in the rectum or left colon, and at a more advanced stage. We urgently need to understand better why the rates in younger adults are trending in the wrong direction.
These findings remind me of the importance of cancer screening. The age to start colorectal screening depends on several factors, such as family history, personal medical history, and risk factors. However, the American Cancer Society recommends the following:
People at average risk for colorectal cancer begin regular screening at age 45. This recommendation changes from a previous recommendation of starting screening at age 50.
For individuals with a family history of colorectal cancer or certain genetic syndromes, screening may need to start earlier, sometimes as early as age 20 or 25. It is important to discuss your risk factors and screening options with your healthcare provider to determine when you should start screening and how often you should be screened.
In addition, please watch for symptoms such as rectal bleeding, changes in bowel habits, and abdominal discomfort.