In recent years, colorectal cancer diagnoses and deaths among people younger than 50 years of age have increased, leading the American Cancer Society to update their screening recommendations. It now recommends that people with an average risk of colorectal cancer begin regular screenings at age 45 years.¹

Just how much is colorectal cancer increasing in younger Americans, and what advice can medical professionals give them on preventive steps?

How Much Is Colorectal Cancer Increasing?


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In the past, colorectal cancer was more likely to affect older people, but research is showing that colorectal cancer diagnoses are declining in Americans aged 65 and older while increasing in younger people. It was estimated that in 2020, nearly 18,000 colorectal cancer diagnoses would be made in people aged 50 years and younger and would account for 12% of all colorectal cancer diagnoses.²

In November 2020, the National Cancer Institute said that the rate of colorectal cancer in adults younger than 50 years of age has doubled since the 1990s.³ According to its research, from 2012 to 2016, colorectal cancer was the deadliest type of cancer for men aged 20 to 49 years, and the third deadliest cancer for women aged 20 to 49 years. The American Cancer Society states that during those years, colorectal cancer increased 2% each year in people under 50 years of age and 1% each year in people aged 50 to 64 years.⁴

What Might Be Causing the Increase?

According to the American Cancer Society, not enough people at risk for colorectal cancer are receiving screenings.² It found that in 2018, less than half of people aged 50 to 54 years were up to date on colorectal cancer screenings. They also found screening rates to be low among people who struggled to afford or find access to colorectal cancer screenings, such as those without insurance or who were on Medicaid.

The COVID-19 pandemic has also created problems for cancer screenings. Liddy Hora of the American Cancer Society in Iowa spoke to The Gazette in April and claimed that not only do 4 out of every 10 people who should be screened for colorectal cancer not get screened but that they’ve seen a 33% decrease in cancer screenings as a result of the pandemic.⁵ Screenings are crucial for colorectal cancer treatment because the earlier this cancer is detected, the easier it is to treat and the greater is the chance for survival.

In terms of lifestyle factors, the National Cancer Institute suggested that unhealthy diets could play a role.³ It links diets with high levels of processed meats and fats and low levels of fruits and vegetables to an increased risk of colorectal cancer, and claims these unhealthy diet choices can promote certain gut bacteria and inflammation and their harmful effects. 

Educational Preventive Steps

The most important way to educate patients about preventive steps may be to stress the importance of colon cancer screenings. Work with patients to make the process more convenient for them; if they haven’t been able to come in for screenings because they can’t take time off work, perhaps recommend an at-home screening option.

Recommending lifestyle changes can help as well. Steering patients away from diets high in red meat and toward diets higher in whole grains, fruits, and vegetables can help reduce their colorectal cancer risk, add vitamins to their diet, and maintain a healthy weight. When relevant, patients should also be encouraged to quit smoking and cut back on alcohol intake and to increase their physical activity. 

References

1. American Cancer Society guideline for colorectal cancer screening. American Cancer Society. https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html. Revised November 17, 2020. Accessed May 10, 2021.

2. Colorectal cancer rates rise in younger adults. American Cancer Society. https://www.cancer.org/latest-news/colorectal-cancer-rates-rise-in-younger-adults.html. Published March 5, 2020. Accessed May 10, 2021.

3. Why is colorectal cancer rising rapidly among young adults? National Cancer Institute. https://www.cancer.gov/news-events/cancer-currents-blog/2020/colorectal-cancer-rising-younger-adults. Published November 5, 2020. Accessed May 10, 2021.

4. Key statistics for colorectal cancer. American Cancer Society. https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html. Revised January 12, 2021. Accessed May 10, 2021.

5. Campbell C. Colon cancer on the rise in people under 50. The Gazette. https://www.thegazette.com/health-wellness/colon-cancer-on-the-rise-in-people-under-50/. Published April 29, 2021. Accessed May 10, 2021.

This article originally appeared on Gastroenterology Advisor