The rate of colorectal cancer has been rising among young adults (below 50) since the 1990s although the rate of colorectal cancer has been decreasing among older adults. The causes and preventative measures of early-onset colorectal cancer are largely unknown and require more research, funding, and awareness. In September of 2020, the National Cancer Institute (NCI) and the National Institute of Environmental Health Sciences (NIEHS) organized a think tank to identify research objectives and questions concerning the disease including prevention, treatment, survivorship, risk factors, and causes. Furthermore, there is a racial disparity amongst young people being diagnosed with colorectal cancer which includes an increased risk among African Americans. According to Jeffrey K. Lee, M.D., from Kaiser Permanente Northern California, the issue amongst young people who are facing early-onset colorectal cancer is not just prominent in the United States, but in Canada, New Zealand, and Australia.
Risk factors of colorectal cancer development among older people include obesity, lack of physical activity, and smoking and have been becoming more common in the past few decades which may correspond to the increase in early-onset colorectal cancer. Additionally, according to Kimmie Ng, M.D., from Dana-Farber Cancer Institute, genetic conditions increase the risk of early-onset colorectal cancer among 10-20% of early-onset cases and the generational changes of the disease may be due to environmental reasons.
There are three main possible causes of early-onset colorectal cancer cases which include: diet, gut bacteria, and inflammation. Diets including high processed meat and fat and low fruits and vegetables have been linked to early-onset cases according to numerous evidential sources. According to Nathan Berger, M.D., from Case Comprehensive Cancer Center, 50% of individuals with early-onset colorectal cancer were overweight while 17% were obese. And this is in trend with the rise in unhealthy diets over recent decades. Furthermore, lack of physical exercise has increased among Americans and studies have indicated a positive correlation with television time and a higher risk of early-onset cases according to Yin Cao, Sc.D., M.P.H., from Washington University in St. Louis. Moreover, certain bacteria have been linked with the growth of colorectal cancer which is affected by diets. Gut bacteria and unhealthy diets may lead to increased inflammation, as well.
So, what do we know about preventative measures and treatment for early-onset colorectal cancer? Recommending lifestyle changes and screenings for patients with an increased risk of developing colorectal cancer under their healthcare professionals may be some preventative measures that could be enacted. Furthermore, medical organizations have begun to lower the recommended age for colorectal screenings from 50 to 45. By researching the risk factors associated with early-onset cases, the specific molecules causing the growth and development of colorectal cancer among young adults may be identified which may lead to developments in treatment and screenings.
So, what can we do now? The simple answer is to spread awareness about the signs of colorectal cancer. According to Yale Medicine, some of the symptoms to look out for include rectal bleeding, unusual stools, changes in bowel movements, and low energy/tiredness. But most importantly, the narrative of colorectal cancer being an “old person’s disease” needs to be altered to effectively communicate the detrimental concern over rising colorectal cancer development among young people.
References:
https://www.cancer.gov/news-events/cancer-currents-blog/2020/colorectal-cancer-rising-younger-adults
Written by: Leah Guven