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More Young People Are Being Diagnosed with Colorectal Cancer

Here's What You Need to Know and Why You Should Get Tested

Posted by Christina J. Seo, MD, Colon and Rectal Surgery Specialist at Holy Name Medical Center on March 20, 2019

Christina J. Seo, MD, Colon and Rectal Surgery Specialist - Holy Name Medical Center

Since its peak in the mid-80s, deaths from colorectal cancer have dropped by more than 45 percent. That's the good news.

But as the disease declines in adults age 50 and up, there's some bad news. Colorectal cancer is now killing more people in their 20s through 40s.

According to the American Cancer Society, people born in 1990 have double the risk of developing colon cancer and four times the risk of getting rectal cancer compared to those born in 1950.

What's behind this shift to younger generations? Christina J. Seo, MD, colon and rectal surgery specialist with Holy Name, separated fact from fiction when it comes to this deadly disease.

What's Behind the Rise of Colorectal Cancer in Young People?

“It's really puzzling why younger people are getting colorectal cancer; we don't know the exact reason,” said Dr. Seo.

There is one potential culprit scientists are now studying: obesity. “In the past, colorectal cancer was mainly diagnosed after middle age,” said Dr. Seo. “The shift may be due to the fact that more and more young people are being diagnosed with obesity, which may be associated with inflammation in the body.”

How Does Inflammation Lead To Cancer?

“When your body's inflammatory response goes haywire, it does not work as well to fight off disease,” explained Dr. Seo. Additionally, people who are obese tend to have higher levels of a protein known as CRP, a marker for colon cancer.

If You’re Diagnosed Younger, Don't You Have a Better Rate of Survival?

“It is not your age, but the earlier you are diagnosed that results in the better rate of survival,” she stated. If the cancer has a chance to advance to a later stage by the time it is diagnosed, then survival goes down. Cancers that reach stage III or IV are more difficult to treat and will need more than just surgery. Because most people younger than 50 years of age don’t have a reason to get tested for colorectal cancer, the cancer grows unchecked. Symptoms tend to be insignificant and are therefore ignored. On the flip side, someone with few medical problems will likely do well with surgery and treatment.

What Are the Early Symptoms?

“The short answer is: none,” said Dr. Seo. Early signs can be vague, such as minor bleeding in your stool, a change in bowel habits, unintentional weight loss, or abdominal pain. But these can be viewed as not serious in the lives of young, healthy, active people.

Can Colorectal Cancer Be Prevented?

“Screening is crucial to prevention,” said Dr. Seo. “Evidence suggests screening can prevent 60 percent of colorectal cancer-related deaths.” As a response to the incidence in younger people, the American Cancer Society and the American Society of Colon and Rectal Surgeons released updated screening guidelines. “The new guidelines recommend that adults with an average risk of colorectal cancer should start getting tested at age 45, five years younger than previous recommendations,” she added.

What Makes Someone High Risk for Colorectal Cancer?

According to the American Cancer Society, individuals are considered to be high risk if they have the following factors:

  • A personal history of colorectal cancer or certain types of polyps
  • A family history of colorectal cancer
  • A personal history of inflammatory bowel disease, including ulcerative colitis or Crohn's disease
  • A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer/HNPCC)
  • A personal history of getting radiation to the abdomen or pelvic area to treat a prior cancer

What is the Test?

The most widely used test is a colonoscopy because it is the only screening that enables physicians to detect and remove polyps before they become cancerous. If cancer is already present, a colonoscopy can be used to biopsy the tumor and mark it for later treatment.

“Unfortunately, many people avoid having colonoscopy out of fear or embarrassment,” said Dr. Seo. “Colonoscopies aren’t as bad as you may think. Patients receive sedation to help them relax and sleep for the procedure. Newer versions of the bowel prep for the night before are much more tolerable than those used in the past.”

What if The Tests Find Something?

“Colorectal cancers are highly treatable and have a 90 percent five-year survival rate if detected early,” said Dr. Seo. If found early enough, colon and rectal cancers can be cured with surgery alone, without chemotherapy or radiation therapy.

Are There Any Other Testing Options?

Although a colonoscopy is the gold standard of testing, if having one still makes you uncomfortable, there are other options: a virtual colonoscopy (a CT version with 3D models of the colon) and stool-based tests (fecal immunochemical test/FIT and Cologuard®), which get sent away to test for blood or DNA.

“We’re happy to discuss screening options and come up with the best one for you, as well as determine what type of screening schedule you should follow based on your individual risk,” said Dr. Seo.

To learn more about colorectal cancer screening, call the Patricia Lynch Cancer Center at Holy Name at 201-541-5900 or visit our website: holyname.org/gastroCancers/colorectal.aspx

To make an appointment with a Holy Name gastroenterologist or colorectal surgeon, visit holyname.org/physician