Colorectal cancer, cancer in the colon or rectum, is typically considered something you don’t have to worry about until after you hit middle age. And while 90% of colorectal cancer cases occur in people over age 50, colorectal cancer is increasing in younger adults, between the ages of 20 and 49.
It’s important to note that the overall number of cases is still quite low. In 2010, there were only about 4,000 cases of colorectal cancer in people under the age of 50 in all of America.
The concerns are two-fold: We are seeing this increase at the same time we are seeing a decrease in cancer in people over 50 and the cancer that is being found in younger people is more advanced.
Colorectal Cancer Increasing in Younger Adults, Decreasing in Older Adults
Between 1975 and 2010, colorectal cancer in adults over age 50 decreased by about 1% every year. We believe that is due to the increased use of colonoscopies, which can remove pre-cancerous polyps. (Still, only about two-thirds of Americans are getting recommended colorectal cancer screenings, such as a colonoscopy every 10 years starting at age 50 if you are at normal risk.)
During this same period, the incident rate of colorectal cancer in younger people increased. According to a study published in Cancer in January 2016, about one in every seven cases of colon cancer are now in people under 50.
- 2% for people ages 20 to 34
- 1/2% for people ages 35 to 49.
In an earlier study, researchers found that the number of cases in people 20-34 increased 2% between 1975 and 2010 and estimated it would double in 15 years by 2030. It is important to keep in mind that we are still talking about relatively small numbers. By 2030, the expected increase would result in 1,500 cases compared with about 400,000 cases in people over age 50.
More Advanced Stage of Colorectal Cancer Under 50
Just as worrisome as the increase in the incidence of colon cancer under the age of 50 is that the cancer being detected is typically more advanced in these individuals. The more advanced the cancer, the more difficult it is to treat. The reason behind this, researchers believe, is that younger people tend to ignore symptoms of early colorectal cancer and they also are not being screened. Any of the following symptoms should be reported to your doctor:
- Blood in the stool
- Weight loss when you’re not trying to lose weight
- Diarrhea, constipation, or other changes in bowel habits that last more than a few days
- Feeling that the bowel does not empty completely
- Cramping or abdominal (belly) pain or discomfort
- Constant fatigue
- Unexplained weakness
Causes of Increased Rate of Colorectal Cancer Under 50
Although there have been many studies on the cause of colorectal cancer, there still are no clear links. And no one is quite sure why it is going up so quickly in younger people. While there is a hereditary cancer syndrome (called Lynch Syndrome) that increases the risk of colorectal cancer in young adults, that number has not changed much and the increase is being seen in many patients who do not have Lynch Syndrome.
At this point, some studies have shown a link between lifestyle factors and colorectal cancer. Until we know more, we recommend that people:
- Eat a healthy diet low in animal fats and high in vegetables, fruits and whole grains
- Limit alcohol use
- Avoid tobacco use
- Exercise regularly
- Report symptoms to their doctor
Advanced Treatment for Colorectal Cancer
If you do have colorectal cancer, Rocky Mountain Cancer Centers will help you aggressively fight the disease. Read about our advanced treatments for colorectal cancer.