Mayo Clinic Minute: Colorectal cancer rates rising among younger people
Why Is Rectal Cancer Increasing Among Younger People?
Researchers found that certain lifestyle factors and genetics can increase a young person's risk of developing colon cancer.
By Valentine Nfonsam, MD, FACS
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June 4, 2019
Colonoscopy, a dreaded but highly recommended procedure that helps detect and prevent colorectal cancer (CRC), is typically not something to worry about until your fifties. But recent studies show that this form of cancer is increasing among people under age 50.
Researchers aren’t sure why this is happening, especially because CRC has generally been declining in the United States and death rates have decreased. So we took a deeper look at the risk factors contributing to this new phenomenon, specifically in rectal cancer.
In a study presented at the medical meeting Digestive Disease Week 2019, my team and I found some noteworthy correlations that we believe could be helpful in beginning to reverse this trend.
Our study looked at 68,699 patients with rectal cancer between 2010 and 2012. During this three-year period, the incidence among patients under age 50 increased significantly — 2.8 percent, 3 percent, and 3.4 percent annually. Our research found that patients with a family history of rectal cancer were more likely to develop the disease. It also found that alcohol use and obesity were correlated with early-onset rectal cancer. Additionally, we noted there was an increased incidence in white females. For these younger-onset patients, the most common symptom was bleeding.
These risk factors, some of which contribute to other health problems, such as diabetes, heart disease, and liver disease, are important for patients to recognize and discuss. I encourage patients who have these risk factors to adopt healthier habits, including improving diet, increasing exercise, quitting smoking, and reducing alcohol consumption.
Unfortunately, younger patients are often found to already have an advanced stage of cancer due to a delay in diagnosis, making this research increasingly important. The symptoms that turn out to be rectal cancer — including abdominal pain, sudden weight loss, and blood in the stool — could be caused by other, less serious conditions, so doctors don’t always screen for CRC in this younger age group.
Patients should be advocates for themselves. If you feel something is wrong, you should insist on getting screened or getting a second opinion. But I also tell my patients not to jump to conclusions too quickly. Ninety-five percent or more of younger patients with blood in their stool do not have colorectal cancer, so it remains a relatively low risk.
The American Cancer Society recently updated the recommended age to begin screening for colon cancer to 45.
Our other studies have shown that there are specific genes that are uniquely expressed in early onset rectal cancer, which shows that the tumor biology might be different. We also believe that environmental factors, such as changes in the gut microbiome, play a role in the development of early onset CRC.
While additional research on this topic is necessary, the identification of risk factors associated with early-onset rectal cancer is an important step towards prevention of this disease. We hope that our study will serve as another reminder about the importance of healthy lifestyle choices and being proactive with your health if you feel something isn’t quite right.
Valentine Nfonsam, MD, is an associate professor of surgery and the program director for the general surgery residency program at the University of Arizona in Tucson.
Dr. Nfonsam presented data from the study “Rectal Cancer in the Young; Analysis of Contributing Factors,” abstract Tu1682, on Tuesday, June 5, from noon–2 p.m. EDT, at the Walter E. Washington Convention Center in Washington, DC. For more information about featured studies, as well as a schedule of availability for featured researchers, please visitwww.ddw.org/press.
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