ASK THE DOC: Why is colorectal cancer rising in young adults?

QUESTION: Why is colorectal cancer on the rise in young adults?

ANSWER: The death rate from colorectal cancer (CRC) has been steadily dropping in both men and women for several decades, in those over the age of 50 due to regular colonoscopies and lower rates of smoking.  Unfortunately, since the 1990’s the rate of CRC has been steadily increasing among adults younger than 50 and the rate of death due to CRC has been increasing in younger adults as well.  The American Cancer Society recently reported that people born in 1990 have double the risk of developing colon cancer and quadruple the risk of developing rectal cancer, when compared to someone born in 1950.  This is a real concern, as it is predicted that CRC will become one of the leading causes of cancer deaths in adults between the ages of 20 and 49 in the next two decades.

No one really understands why the numbers are rising in young adults, but research is ongoing. A family history of CRC or colon polyps are known risk factors in the development of CRC, but only account for about 20% of cases.  The rates of genetic syndromes that predispose to developing CRC at a younger age, such as Lynch syndrome or familial polyposis syndrome has not increased, so does not explain this change.  Likely this change will boil down to environmental or dietary factors or other factors that have yet to be identified.  

Some factors that have been identified include sedentary lifestyle, overweight, obesity, smoking tobacco, heavy alcohol use, unhealthy diet, low-fiber, high-fat diets or diets high in processed meats or red meats, and other environmental factors.   

What are symptoms of CRC and what can you do to prevent it?  Symptoms such as rectal bleeding, even if is just some blood on the toilet paper after a BM, should be reported to you doctor.  Changes in the consistency of your stool that lasts more than 2 weeks or a change in the diameter of the stool, especially if it becomes narrow, like a ribbon, should be reported.  If you find yourself tired or without energy, that should be reported as that could be a sign of anemia from blood loss. Lifestyle modifications can help reduce one’s risk of developing CRC.  Losing weight, even just a small amount can make a difference.  Eating less red meat or processed foods, increasing your whole grains, fruits and vegetables help and getting out for exercise, even frequent walks can make a difference. 

If you are experiencing any of these symptoms, please follow up with your family doctor or call Robert C. Byrd Clinic to make an appointment.

 This question from a reader was answered by Rachel Johnson, DO, FACOFP. She practices at Robert C. Byrd Clinic in Lewisburg.

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