Colon Cancer Is Hitting Millennials Really Hard
More young people are being diagnosed with colorectal cancer. Here's what you need to know.
Colorectal cancer may be on the decline, but…
The tragic death of Chadwick Boseman is a reminder that the colon and rectal cancers are not going away. Colorectal cancer is still the third most common cancer in the United States, with over 104,610 new cases expected to be diagnosed this year, according to the American Cancer Society. Men have a 1 in 23 risk of developing the disease, while women fare a bit better at 1 in 25. “Rates have been steadily decreasing over the past few decades, largely as a result of increased colonoscopies,” says Jerald D. Wishner, MD, director of the minimally invasive and colorectal surgery program at Northern Westchester Hospital. Still, as many as half of Americans who should be getting colon cancer screenings, aren’t, which is why some 50,000 die from colorectal cancer each year, according to the U.S. Centers for Disease Control and Prevention (CDC).
But it’s on the rise for younger people
Boseman’s battle with colon cancer underscores a trend in the numbers: There’s a curious increase in the disease for younger Americans. According to the Journal of the National Cancer Institute (JNCI), “colon cancer incidence rates increased by 1.0 percent to 2.4 percent annually since the mid-1980s in adults age 20 to 39 years and by 0.5 percent to 1.3 percent since the mid-1990s in adults age 40 to 54 years.” While these numbers may seem small, more and more research points toward this trend.
A recent analysis from Canadian researchers also found that the number of women under 50 diagnosed with colorectal cancer increased by 4.5 percent every year from 2010 to 2015. For Canadian men under 50, the number of diagnoses increased by almost 3.5 yearly from 2006 to 2015. So it makes sense that the American Cancer Society revised its guidelines and recommends that adults now get screened for colorectal cancer a full five years earlier than their previous recommendation—at age 45 instead of 50. The policy shift is based on a study showing a 51 percent increase in colorectal cancer (CRC) from 1994 to 2014. That means the risk for someone born around 1990 being diagnosed with colon cancer is twice as high (and for rectal cancer four times as high) as it is for someone born in 1950. That’s a concerning rise. So if these trends continue, and younger people aren’t screened earlier than previously recommended, the general decline of colorectal cancer could stop—and the overall rate could start to rise.
Their cancers may be more deadly
Initiating routine screening with colonoscopies was a game-changer because it has allowed doctors to find cancerous polyps (growths in the lining of the colon) early or when they’re still precancerous. However, sometimes young, healthy adults don’t have a doctor or don’t get seen regularly, so potential concerns never get addressed in the first place. Being traditionally healthy, they also may blow off symptoms. These are the colon cancer signs you might be ignoring.
Young patients do walk through the doors
When Gina Neri was 39, she saw her doctor for rectal bleeding. He then referred her to a GI specialist for testing, and she was diagnosed with colon cancer. Around the same time, she also learned she was pregnant with her third child. “This was the first time I’ve seen it in 30 years—a pregnant woman with colorectal cancer,” says Dr. Wishner who treated Gina. Because of early detection and swift action on the part of her doctors, Gina received a successful operation to remove the tumor, and she was able to deliver a healthy baby girl.
Unless there’s a reason for a colonoscopy
If you have a first-degree relative diagnosed with colorectal cancer, you should be screened 10 years earlier than the relative’s age when they had it. So if your mom was diagnosed at age 45, you should get screened at age 35. Here are doctors’ insider tips on how to make getting a colonoscopy easier.
Pay attention to your bathroom habits
“This disease is an equal opportunity offender and you have to be aware of the symptoms,” says Dr. Wishner. You might see blood on the toilet paper after you wipe or notice a sudden change in bowel habits, like diarrhea, constipation, mucousy stools, cramps or pain, or stools that become narrower in shape, which can all be indications of colorectal cancer symptoms. Overwhelmingly it will not be cancer, and will more likely be something like hemorrhoids, lack of fiber in your diet, or those spicy tacos you ate yesterday. These are the foods cancer doctors try to avoid.
You’ll know it something more when symptoms stick around
Everyone experiences occasional constipation or eats something that doesn’t agree with them. So if these symptoms crop up, don’t panic and assume the worst. The good news is that the cancer doesn’t advance overnight, says Dr. Wishner. It’s OK to wait a couple of weeks or a month to see if your symptoms resolve. If not, bring them to the attention of your doctor. And especially if you have a family history of the disease, you should be taking these proactive steps to prevent colon cancer.
Your symptoms may be overlooked
Truth be told, when doctors see a 70-year-old with diarrhea or constipation, they’ll at least think about cancer. With a young, healthy-looking patient, they may brush off the complaint and tell them to go home and take a laxative. To advocate for yourself, don’t be afraid to ask your doctor questions or say, “what else could this be?” advises Dr. Wishner. Tell them that you know about this data on the spike in colorectal cancers among Millennials. “This is news to a lot of doctors,” he says.
Don’t be afraid of the colonoscopy result
Many patients don’t want to get a colonoscopy because they’re afraid of what a positive cancer diagnosis might mean. However, Dr. Wishner says that with current technology, most colorectal cancers that are found early are cured with surgery alone, most patients don’t need chemo, and surgery has become more precise. Dr. Wisher performs minimally invasive robotic surgery, which results in tiny incisions, less pain, and shorter recovery. “If you do have it you need to find out—and the earlier the better,” he says.
It’s all about your lifestyle
Obesity, lack of exercise, and a poor diet are all big drivers of colon cancer. For instance, eating a diet of fast food and highly-processed foods triggers inflammation in the gut that may put you at higher risk, reports the JNCI study. Make sure you’re staying active (get the recommended 150 minutes of moderate-intensity exercise per week), eating a good amount of fiber from veggies, fruits, legumes, and whole grains (it’s what sweeps out your colon), and use those healthy habits to help you maintain your weight. Your gut—and everything else—will thank you.
- American Cancer Society: Key Statistics for Colorectal Cancer
- Jerald D. Wishner, MD, FACS, director of the minimally invasive and colorectal surgery program at Northern Westchester Hospital
- Centers for Disease Control and Prevention: "Colorectal Cancer Awareness"
- JAMA Network Open, Original Investigation — Oncology: "National Trends in Colorectal Cancer Incidence Among Older and Younger Adults in Canada"
- Journal of the National Cancer Institute: "Colorectal Cancer Incidence Patterns in the United States, 1974–2013"
- A Cancer Journal for Clinicians, American Cancer Society: "Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society"