Colorectal Cancer on the Rise in Young Adults

An article from Dr. Hari Nair, a medical oncologist at Bronson Oncology and Hematology Specialists.

Colorectal cancer is one of the most common forms of cancer that is diagnosed in the United States. In 2020, the CDC reported 3,800 cases of colorectal cancer in the state of Michigan. Traditionally, colorectal cancer has been diagnosed most commonly in older adults, ages 65+. However, recent studies show this disease is on the rise in younger adults. Cases among people under age 55 has nearly doubled in the last 24 years - from 11% in 1995 to 20% in 2019. In fact, colorectal cancer has become the leading cause of cancer deaths for Americans age 20 to 49, according to the National Cancer Institute!

In a 2023 study from The American Cancer Society (ACS), an estimated 19,550 people will be diagnosed with colorectal cancer and 3,750 colorectal cancer-related deaths will occur in people younger than 50 this year. The same study concluded, “Colorectal cancer is rapidly shifting to diagnosis at a younger age and at a more advanced stage.”

Why is Colorectal Cancer on the Rise?

While experts have not determined the cause of this increase in young adults, doctors do know there are some specific risk factors.

Age remains a major risk factor. ACS recommends routine colorectal cancer screenings beginning at age 45. In response to rising rates of colorectal cancer in those younger than 50, the American Cancer Society lowered the recommended age to start screening at 45 for those at average risk. It had previously recommended screening starting at age 50.

Additionally, genetics and family history play a role in colorectal cancer. Those with a family history of colorectal cancer should begin screening 10 years earlier than the age the family member was when they were diagnosed.

How to Reduce Your Risk of Colorectal Cancer

While colorectal cancer is often highly treatable, catching it in the early stages plays a large role in the success of treatment. To reduce your risk of developing colorectal cancer, particularly at younger ages, consider the following lifestyle changes:

• Maintain a healthy body weight. Individuals who are overweight or obese are at a higher risk of developing colorectal cancer.
• Stay active. It’s important to keep your body healthy through movement. Try spending 30 minutes a day, five days a week, participating in physical activity.
• Maintain a healthy diet. Focus on eating fresh whole foods and reducing processed foods and red and processed meats.
• Quit Smoking. Smoking increases your risk for colorectal, lung and many other forms of cancer.
• Reduce alcohol consumption. Moderate to heavy drinking correlates to an increased risk of developing colorectal cancer.

Symptoms of Colorectal Cancer

If you notice one or more of the symptoms below, talk to your primary care provider. Though they can be a sign of many different health concerns, they are warning signs of colorectal cancer.

• A consistent change in your bowel habits, including constipation or diarrhea
• Abdominal pain
• Bleeding during a bowel movement or blood in your stool
• Feeling that your bowel isn’t completely empty
• Unexplained weight loss

Screening Options for Colorectal Cancer

A traditional colonoscopy is not the only screening option to detect colorectal cancer. There are several non-invasive screening tests available. A positive or abnormal result from one of these tests can indicate that a colonoscopy test is needed for a closer view of the colon.

A fecal occult blood test is used to detect blood in the stool. The test uses a chemical to detect blood in a stool sample. The sample is collected at home by the patient and returned to the lab. Test kits are available from your doctor. This type of test is often done on an annual basis.

The fecal immunochemical test (FIT) is also used to detect blood in the stool. Different from a fecal occult blood test, the fecal immunochemical test uses antibodies to detect blood in a stool sample. Collection of the sample is done in the same manner as the previous test and is also performed on an annual basis.

A FIT-DNA test enlists the same technology to detect blood in the stool as with the FIT test, combined with a test that detects altered DNA in the stool sample. A FIT-DNA test involves the collection of an entire bowel movement as opposed to a smaller sampling for the other tests. This test only needs to be done once every three years.

CT Colonography, also known as a virtual colonoscopy, a Computed Tomography (CT) colonography uses X-rays and computers to provide images of the colon. The images are then analyzed by a doctor. A CT colonography is performed once every five years.

Flexible Sigmoidoscopy is similar to a colonoscopy in that a thin, flexible tube is inserted into the rectum. The lighted tube allows the doctor to visually check for polyps or other areas of concern. The doctor is able to remove most polyps and possible cancer during the screening and have it tested. Unlike a colonoscopy, a flexible sigmoidoscopy is used to check only the rectum and lower third of a colon. This test is performed every five years, or every 10 years when used with an annual FIT test.

Colonoscopy is similar to a flexible sigmoidoscopy, a colonoscopy uses a thin, flexible, lighted tube. However, the tube for a colonoscopy is longer. The doctor is able to check the entire colon during the test. Because the colonoscopy is such a thorough test, it only needs to be performed once every ten years if the results of the test are normal. It is only done more frequently if an initial colonoscopy detects polyps or cancer.

Tests such as the fecal occult blood test and flexible sigmoidoscopy, which have been used in the past, may no longer be considered the preferred choice as other similar tests are often seen as a better option. Which test is right for each person is determined on a case-by-case basis. Your doctor will review health status, family history and results of previous tests to help decide which test is most appropriate. You can speak to your primary care provider about which screening option is best for you.

Colon & Rectal Services at Bronson

Our board certified specialists are here for you during every step of your colorectal health journey. The team at Bronson Gastroenterology Specialists specializes in the diagnosis and treatment of diseases of the digestive system. The cancer experts at Bronson Cancer Center treat cancer with a comprehensive approach to care, including surgery, chemotherapy and radiation, as well as survivorship programs and ongoing supportive care.

More About Colorectal Cancer

Want to learn more about colorectal cancer? Check out the additional articles below:

• Colorectal Cancer More Likely to Affect Black Community
• Screenings are the Key to Detecting, Treating and Beating Colorectal Cancer
• Screening Options for Colorectal Cancer
• Recognizing, Diagnosing and Treating Colorectal Cancer

For additional information on colorectal cancer, you are encouraged to visit cancer.org or speak with your primary care provider. Looking for a Bronson doctor? Visit bronsonhealth.com/find-a-doctor or contact Bronson Care Advisors at (269) 341-7788. They can help you or a family member choose a provider based on your personal preferences, medical needs, insurance and location. They can even help schedule your first appointment. 

Hari Nair, MD

Hematology, Medical Oncology

“I strongly believe in providing my patients with care that is both individualized and comprehensive. As your physician, I love getting to know you as a person, listening to your concerns and learning about your unique needs. I offer patients a thorough understanding of their condition, discuss in detail the treatment options and go over any cutting-edge therapies and clinical trials available. My patient’s individual opinions and priorities are the centerpiece of my care throughout our journey together.”

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