Colon cancer in young people rises, age for screening drops

If you’re 25 and experiencing changes in your bowel movements, or have chronic fatigue or stomach cramps, you might chalk it up to poor eating habits or one too many nights out. However, four “red flag” symptoms you shouldn’t be so quick to ignore — abdominal pain, rectal bleeding, diarrhea and iron deficiency anemia — can also be signs of early-onset colorectal cancer, also known as colon cancer.

Studies show more people in their 20s are being diagnosed with colon cancer than ever before. And this type of cancer is usually diagnosed in young people after it has advanced — when it is harder to treat than if it had been caught at an earlier stage. Additionally, a new study found the “red flag” symptoms can appear up to two years before colon cancer is diagnosed.

The study, recently published in the Journal of the National Cancer Institute, was done to determine if colon cancer in younger people who are not yet of screening age can be identified through the recognition and reporting of symptoms. Early colon cancer diagnosis and treatment can reduce the need for aggressive treatment and save lives.

According to Dr. David Bodkin, a board-certified oncologist and hematologist affiliated with Sharp Grossmont Hospital, colorectal cancer is the third most common cancer diagnosed in the U.S. and the second leading cause of cancer-related deaths. While the rate of colon cancer cases has decreased each year in adults age 65 and older, rates of colon cancer increased every year in people younger than 50. In fact, the American Cancer Society reports 20% of colon cancer cases in 2019 were in people 54 years or younger, up from 11% in 1995.

“Over the last several years, with increased screenings, we’ve seen a decrease of colon cancer in the population over 65,” Dr. Bodkin says. “But what’s worrisome is that in the last 10 years, we’ve seen an increase in people under age 50.”

New screening age now recommended

The increased diagnoses in younger people recently led the U.S. Preventive Services Task Force to lower the recommended age to begin colorectal cancer screening from 50 to 45. Screening can detect polyps and early-stage cancer, which is easier to treat. For people under age 45, Dr. Bodkin recommends they pay close attention to their health.

“Colon cancer can present in many ways,” he says. “Unfortunately, in younger people, it may take a while for the symptoms to be looked at. This can mean they’re diagnosed at a later stage, the cancer may have advanced, and they may have a poorer prognosis.”

The American Cancer Society reports that colorectal cancer can cause one or more of the following symptoms, though symptoms don’t always appear immediately:

• A change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days

• A feeling that you need to have a bowel movement that’s not relieved by having one

• Rectal bleeding with bright red blood

• Blood in the stool, which might make the stool look dark brown or black

• Cramping or abdominal pain

• Weakness and fatigue

• Unintended weight loss

Young people not yet at the screening age who experience any of these symptoms — in particular, the four “red flag” symptoms — should talk with their doctor. For individuals with additional risk factors, such as a family history of colon cancer; a personal history of colorectal polyps, colorectal cancer or inflammatory bowel disease (IBD), including ulcerative colitis or Crohn’s disease; or other inherited syndromes linked to colon cancer, their doctor may recommend early screening.

Lifestyle risk factors you can change

Unlike risk factors related to genetics or your personal history, there are other risk factors that you can change to reduce your colon cancer risk. These include:

• Being overweight

• Not being physically active

• Eating a diet high in red and processed meats

• Smoking

• Using or overusing alcohol

“The rising rate of colon cancer in younger people is alarming,” Dr. Bodkin says. “We have to ask if younger people aren’t exercising enough or eating a healthy diet or are smoking or drinking too much.”

According to Dr. Bodkin, making a few lifestyle changes can lower the risk of colorectal cancer and many other types of cancer. These include getting regular exercise; eating a diet that includes plenty of fruits, vegetables and whole grains, and limits red and processed meats; quitting smoking; and limiting or forgoing alcohol use.

“Early detection is key, no matter your age,” Dr. Bodkin says. “Talk with your doctor about screening if you have any concerns, are 45 or older, or are experiencing symptoms of colorectal cancer.”

Learn more about colorectal cancer prevention and treatment at Sharp HealthCare.