The Rising Trend of Colorectal Cancer Among Young Adults in the US
Colorectal cancer has long been associated with older adults. However, in recent years, the number of young adults diagnosed with the disease has been on the rise. Nikki Lawson is one of these young adults. At the age of 35, she received the shocking news that she had stage III rectal cancer. Her story is not unique, and experts are concerned about the increasing trend of colorectal cancer among young adults in the United States.
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| Increasing Incidence of Colorectal Cancer Among Younger Adults |
Symptoms and Misdiagnosis
Lawson initially experienced symptoms that were similar to those of a stomach ulcer. She had a persistent upset stomach and sudden urges to use the restroom, sometimes with blood in her stool. Despite visiting the hospital for severe symptoms, she was misdiagnosed and sent home. Lawson thought that changing her diet would help alleviate her symptoms, but her health continued to decline.
The Diagnosis
After experiencing persistent low iron levels, Lawson's primary care physician recommended that she see a gastroenterologist. It was then that she received the devastating news that she had rectal cancer. She was shocked and in disbelief, as she had always thought of cancer as a disease that only affected older individuals.
The Growing Trend of Colorectal Cancer Among Young Adults
Lawson's experience is not an isolated case. The incidence of colorectal cancer among young adults in the United States has been steadily increasing since the 1990s. The exact cause of this trend is unknown, and researchers are still trying to determine the factors that contribute to the disease's onset in young adults.
Call for more research on early-onset colorectal cancer
Researchers from Dana-Farber Cancer Institute are urging for more investigation into the rise of colorectal cancer among younger people. In a recent paper published in the journal Science, the researchers suggest establishing more specialized research centers to focus on young patients with the disease, and including diverse populations in studies on early-onset colorectal cancer.
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Their goal is to improve outcomes for young colorectal cancer patients, as the disease is predicted to become the leading cause of cancer-related deaths among people aged 20 to 49 in the US by 2030.
One patient's journey through cancer
Nikki Lawson, a former middle school teacher from Palm Bay, Florida, was diagnosed with stage III rectal cancer at age 35. She received multiple surgeries, radiation therapy, and chemotherapy to treat her cancer, and is now in remission and cancer-free. She encourages other young people to be aware of symptoms and seek medical attention if they notice any changes in their bowel habits, rectal bleeding or blood in the stool, cramping or abdominal pain, weakness and fatigue, or unexplained weight loss.
The mystery behind rising colorectal cancer cases
A report released by the American Cancer Society reveals that the proportion of colorectal cancer cases among adults under 55 increased from 11% in 1995 to 20% in 2019. However, the factors behind this increase remain unknown. Dr. Steven Lee-Kong, chief of colorectal surgery at Hackensack University Medical Center in New Jersey, suggests there is likely more than one cause for the rise in cases among younger people. Although overall colorectal cancer rates have decreased, screening programs have not accounted for the rise in young patients developing the disease.
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| adults under 55 are on the rise in the US |
Factors that Raise Risk of Colorectal Cancer in Younger Adults
Colorectal cancer rates among adults under 55 are on the rise in the US. While certain factors have been identified as raising the risk of colorectal cancer, including family history, genetic mutations, smoking, alcohol consumption, and obesity, the data do not support these factors as solely driving the trend. According to Rebecca Siegel, a cancer epidemiologist and senior scientific director of surveillance research at the American Cancer Society, excess body weight, lack of physical activity, high consumption of processed meat and red meat, and very high alcohol consumption are also associated with early-onset disease. However, the excess risk posed by these factors is relatively small, and thus not sufficient to fully explain the rise in colorectal cancer rates among younger adults.
Healthy Young Adults are Also at Risk
Many young adults being diagnosed with colorectal cancer were not obese, leading some experts to suggest that something else is going on. Anecdotal evidence suggests that these patients are often very healthy and active. While excess weight has been linked to an increased risk of colorectal cancer, it does not fully explain the steep increase in rates among younger adults.
Debate Among Scientists
Scientists are divided on the extent to which known risk factors such as obesity play a role in the rise of colorectal cancer among younger adults. While excess body weight is known to contribute to various cancers, including colorectal cancer, it may not be sufficient to fully explain the increase in rates observed in the US. Further research is needed to identify other factors that may be contributing to this trend.
Debating the Role of Obesity in Colorectal Cancer in Young Adults
Despite ongoing research, the causes of the rise in colorectal cancer cases in younger adults are not fully understood. While genetics may play a role, some experts believe that lifestyle and dietary factors, such as smoking, alcohol consumption, lack of physical activity, increased consumption of red meat, and obesity, may be contributing factors.
Difficulty in Pinpointing the Causes
Pinpointing the causes of the rise in colorectal cancer cases among younger adults is challenging. It can take up to 15 years for a polyp to develop into cancer, and during that time, individuals are exposed to various environmental and lifestyle factors that make it difficult to pinpoint a single cause.
Correlation with Childhood Obesity
Some researchers have explored the possibility that the increase in childhood obesity in the US may be connected to the rise in colorectal cancer cases among younger adults. Childhood obesity rates have doubled in the past 30 years, affecting up to 20% of those under 20. The correlation may lie in the consumption of unhealthy foods, such as fast food, processed snacks, and sugars, which are high in carcinogens and mutagens.
Mixed Findings
While some studies have shown a correlation between obesity and colorectal cancer in younger adults, other studies have yielded mixed findings. At the Center for Young Onset Colorectal and Gastrointestinal Cancers at Memorial Sloan Kettering Cancer Center, researchers and physicians have not found a definite correlation between the rise in colorectal cancer cases among younger adults and obesity.
Continuing Research
Despite the ongoing debate, researchers and physicians continue to work around the clock to solve the mystery of the rise in colorectal cancer cases in younger adults. Follow-up studies are needed to better understand the dietary patterns, medication use, and weight changes that may contribute to the development of colorectal cancer.
Experts cast doubt on genetics' role in the rise of colorectal cancer among younger adults
While some scientists are exploring the possibility that genetic mutations may have contributed to the increase in cases of colorectal cancer among younger adults, experts are skeptical.
Lack of evidence for an increase in genetic mutations
According to Dr. Karnes of UCI Health, it is unlikely that there has been an increase in the genetic mutations that raise the risk of colorectal cancer. While genetic mutations like Lynch syndrome are more common in people with young-onset colorectal cancer, they still only account for a small percentage of cases.
Similar tumors in younger and older patients
Dr. Mendelsohn at Memorial Sloan Kettering Cancer Center notes that the tumors in younger colorectal cancer patients are very similar to those in older patients. This suggests that there may be other factors at play besides genetics.
Exposure to environmental factors
Dr. Mendelsohn believes that exposure to environmental factors like diet, medication, or changes in the microbiome may be driving the rise in colorectal cancer among younger adults. However, the numbers are still relatively small, and the majority of patients do not have a family history or genetic predisposition to the disease.
Surge in Colorectal Cancer Diagnoses Among Younger Ages: Possible Reasons and Solutions
Improved Testing and Diagnosis
According to Dr. Dormady from El Camino Health, there has been an increase in colorectal cancer patients in their early to mid-50s. One possible reason for this is the improved access to and accuracy of diagnostic tools, including at-home colorectal cancer testing kits. Moreover, the recommended age for colon and rectal cancer screening has been lowered from 50 to 45, leading to earlier detection and more screening.
Personalized Risk Assessment
To better understand cancer and develop personalized risk assessments for younger patients, it is crucial to identify what is driving this surge in diagnoses. Most people who develop colorectal cancer do not have a family history of the disease, so they may not be aware of their risk until they experience symptoms. Developing a personalized risk assessment tool that considers lifestyle, environmental factors, and genetics can help provide individualized recommendations for screening and modalities based on risk.
Different Screening Approaches for Younger and Older Adults
It is important to note that younger adults tend to develop colon cancer on the left side, while older adults tend to develop it on the right side. Thus, there may be a difference in how we should screen younger and older adults for colorectal cancer. By identifying these differences, doctors can provide more effective screening and prevention strategies for their patients.