New Brunswick, N.J., March 1, 2024 – Colorectal cancer (CRC) is on the rise in young adults. Incidences of colorectal cancer in young people (those between their mid-20s and late 50s) has more than doubled since the 1990s. According to the American Cancer Society 2023-2025 Colorectal Cancer Facts & Figures, 20 percent of colorectal cancer diagnoses in 2019 were in patients under age 55, and rates of advanced disease increased by about 3 percent annually in people younger than 50.
Howard S. Hochster, MD, FACP, director of the Gastrointestinal Oncology Program and Rutgers Cancer Institute of New Jersey Associate Director for Clinical Research and director of Oncology Research, RWJBarnabas Health, shares his thoughts on this trend.
Nobody knows for sure why colorectal cancer numbers are rising in young people. Lifestyle factors like poor diet, diets high in processed meats, obesity, smoking and heavy alcohol have all been associated with onset of colorectal cancer. Additionally, family history of colorectal cancer or polyps, and conditions such as inflammatory bowel disease are also risk factors.
Should young people get colonoscopies? The rate of colorectal cancer diagnoses in younger people prompted the American Cancer Society and the United States Preventative Task Force (USPTF) to change their screening recommendations in 2021 to start at the age of 45 instead of 50. If you have a family history of colorectal cancer, your doctor may recommend colonoscopy screening at age 40 or 10 years before the age when your family member was diagnosed.
Younger people may not seek colon cancer screening upon their first symptom because of a misconception that it's an unlikely diagnosis. This can delay diagnosis, which gives the cancer time to progress to a later stage. Earlier screenings along with recognizing the signs of colorectal cancer and taking them seriously may help curb this trend. Even if you report some of these symptoms, doctor may not consider them serious in young people. If you feel something is “wrong” and your doctor does not investigate seek an opinion from a gastroenterologist.
Young people—and everyone else—need to communicate with their doctor if they notice any symptoms. These include blood in stool, unusual stool, changes in bowel pattern, bloating, cramping, weight loss, and fatigue.
As with most cancers, making positive lifestyle choices can reduce the risk of colorectal cancer. A balanced, low-fat diet with the recommended amount of daily dietary fiber, as well as maintaining a healthy weight and limiting alcohol consumption can help decrease one's risk of cancer. Regular physical activity can also improve general health. However, the most influential choice is likely to be quitting smoking, which not only decreases the risk of colorectal and other cancers, but also increases general life expectancy by as much as 10 years.
Rutgers Cancer Institute together with RWJBarnabas Health, the state’s leading cancer program and only NCI-designated Comprehensive Cancer Center, is a statewide resource in advancing our understanding about colorectal cancer. Request a colorectal cancer screening appointment: rwjbh.org/colonscreening.
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