Medical professionals across the United States are increasingly alarmed at the growing number of younger people developing colorectal cancer.

“Over the last couple decades, published data are showing a rise in this cancer among a younger age group — especially in patients in their 40s and early 50s,” said Dr. Daniel Langer, a board-certified gastroenterologist and member of the medical staff at UCHealth Yampa Valley Medical Center. “Also, many younger patients may have a delayed diagnosis that may contribute to a more advanced stage of cancer by the time we see them.”

This trend is frustrating for the medical community, as the numbers of colorectal cancer diagnoses and deaths have decreased for older Americans, which is likely related to diligent screening by colonoscopy. Lifestyle changes, such as a decrease in smoking, may also contribute. But the proportion of people under age 55 developing colon cancer has nearly doubled from 11% of all cases in the mid-1990s to now about 20%.

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According to a study published in 2021 in the Journal of the American Medical Association, the disease will become one of the leading cause of cancer deaths for Americans 20 to 49 in the next two decades.

Colon cancer is one of the most common types of cancer in America. Age remains one of the biggest risk factors in determining overall risk. There are about 150,000 new cases a year — a third of which will be fatal.

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“When you’re young, you may not think this could happen to you, but we definitely see it from time to time,” Langer said.

What accounts for the cancer surge?

Studies are ongoing and speculation continues, but many health professionals point to growing evidence that shows diet, environmental factors, a sedentary lifestyle and increasing obesity among Americans may play a role in the rise of colorectal cancer among younger adults. Langer said family history and genetics should also be taken into account.

Some research has shown that a diet high in processed food, red meat and alcohol may increase the risk of colorectal cancer. Too much fast-food could affect the colon’s balance of good and bad gut bacteria and may play a role in obesity, which is a risk factor in colorectal cancer.

“There’s a variety of risk factors that may contribute to this increased incidence, but we don’t know the real reason,” Langer said. “We do know that better adherence to screening guidelines for younger adults is key to help reduce the increase in colorectal cancer incidence and mortality.”

Who should be screened and when?

In 2021, national screening guidelines were updated to recommend that someone with no risk factors should have their first colonoscopy at age 45 instead of age 50. If there are other risk factors such as family history, then screening should begin at an earlier age, often age 40 or 10 years earlier than the age at which their first-degree family member was diagnosed, whichever comes first.

But people of all ages, even those in their 20s and 30s, need to pay attention to the potential symptoms of colorectal cancer and see their primary care physician if they experience:

• Changes in bowel habits.
• Unintentional weight loss.
• Blood in stool.
• Nausea, vomiting, fatigue and abdominal pain.

“I sometimes see patients in their 30s — an age when you may think nothing bad is going to happen to you – who have had symptoms going on for some time only to find an advanced stage colon cancer,” Langer said. “One always wonders if we could have found it earlier, perhaps it would have made a difference.”

Ways to reduce your risk

Adopting a healthy lifestyle that includes a balanced diet, exercise and not smoking may help to reduce the risk of colorectal cancer no matter what your age. Not delaying recommended screenings are also key; Langer said less invasive tests are available, although colonoscopies are the “gold standard” as they also can pre-emptively prevent cancer through the removal of pre-cancerous polyps during the procedure.

“See your doctor if you have symptoms. Don’t ignore possible warning signs,” Langer said. “Talk with your family and learn their history. Pay attention to your body, and be aware and educated about screening options and when to start screening. Consult with your doctor about any of these health concerns.”

Mary Gay Broderick writes for UCHealth. She can be reached at marygaybroderick@comcast.net.