Even though the mean age of colorectal cancer (CRC) is about 72 years of age, studies show that there has been a steady increase in colorectal cancer incidence in individuals under the age of 50. More specifically, colon cancer incidence in young people has increased about 2 percent every year for the past 20 to 30 years. This means that since 1994, new diagnoses for colon cancer among the young has increased by 51 percent!
Colon cancer is no longer a disease of the elderly. Everyone is at risk. Thanks to the Affordable Care Act, increased education, and more palatable, simplified bowel preparation methods, colon cancer incidence has decreased among patients over 50 years of age. Even though 90 percent of new cases of colon cancer are still diagnosed in patients over the age of 50, colon cancer incidence among young Americans is still rising.
Why are we seeing this trend?
Doctors and researchers are committed to finding answers as to why colon cancer incidence is increasing among the younger generation. There are three factors that seem to play an integral role in the increase of new diagnoses:
- Genetic/ Hereditary syndromes. About one-third of CRC cases among young individuals arise from hereditary syndromes. If colon cancer is hereditary, it can develop at a younger age. This is dangerous because colon cancer often has no symptoms in the early stages, and the recommended screening age for an initial colonoscopy is 50 years of age.
- Inflammatory Bowel Disease. Crohn's or ulcerative colitis are two forms of inflammatory bowel disease (IBD) which are characterized by inflammation of the digestive tract. The longer people have IBD, the higher chance that they will develop colon cancer in the future. About 10 to 15 percent of patients with young onset CRC have had IBD.
- Environmental factors. This accounts for about two-thirds of the diagnoses. Chemicals, toxins, and oxidative stress are just a few examples of environmental factors that could increase the risk for colon cancer.
What can be done to decrease colon cancer incidence among the young?
Although colonoscopy decreases incidence and death rate of colon cancer, the challenge lies in the fact that at-risk young people are too young to be screened and often do not have symptoms. Doctors have three main opportunities to intervene and prevent colon cancer.
- Clinical opportunity. When evaluating patients in an office visit, doctors can ask questions so they can be aware of family history and symptoms. Young people tend to blow off symptoms like rectal bleeding, but this is highly dangerous. A recent study shows that the average time that it takes from the beginning of symptoms to evaluation is over 200 days for individuals under the age of 50. For those who are above 50, it is only about 30 days.
- When patient is diagnosed. Doctors have the opportunity to try to evaluate whether heredity plays a role. Testing for Lynch syndrome can save lives. Patients’ families can get genetic counseling and can identify the gene(s) responsible for cancer. There are also new panel tests that can help with less common syndromes. If genetic syndrome can be identified in the patient, the family can be spared.
- Try to learn from these young patients. Doctors and researchers can evaluate tumors in labs. They can also try to develop tests to assess colon cancer risk that are cheaper and easier for young people to tolerate (Source: Healio).