Colon Cancer Under 50: Know Your Risks and How to Prevent It

February 24, 2024
Ernie Mundell HealthDay Reporter

SATURDAY, Feb. 24, 2024 (HeathDay News) -- Colon cancer rates are on the rise among young Americans and Americans of color, so much so that the disease is now the leading cause of cancer death for men under 50 and the second most deadly cancer for women under 50.

The American Cancer Society released those statistics in its 2024 Report, causing many experts to call for better screening in younger patients.

The numbers are "alarming," said Dr. Folasade May, a cancer prevention researcher and gastroenterologist at UCLA Health in Los Angeles. She also served on the President's Cancer Panel on Colorectal Cancer in 2021.

"Since 1995, there has been a 45% increase in colorectal cancer diagnoses in people under the age of 50," she noted. The uptick in cases was so dramatic that in 2022 the influential U.S. Preventive Services Task Force lowered the recommended age of first screening from 50 to 45.

Even that move may not be "having enough of an impact," May said in a UCLA news release.

Why the rise in cases among the young?

According to May, the jury is still out on why folks under 50 are becoming more prone to colon and rectal cancers.

"Lifestyle and environmental factors such as chemicals in foods and air are felt to play a role," she said. "Studies have also shown that obesity, alcohol use, tobacco use, physical activity, and even factors from early in life like whether or not you were breastfed or received antibiotics at a high rate as a child might predict your chances of getting cancer when you're an adult."

It's possible that efforts to control some lifestyle factors -- excess weight, alcohol intake, smoking, exercise -- might help lower people's risk.

Race plays a role

Besides the rise in case numbers among the young, Americans of color -- most notably Black people and Native Americans -- face higher risks for colorectal cancer.

"African Americans, for example, are about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups," May said.

The reasons behind that trend aren't clear, but "historically, minority populations have had higher uninsured rates and less access to preventive care, screening and treatment," she pointed out. That could mean cancers in Black patients are spotted later, when treatments are less effective.

Hispanic Americans have lower rates of colon cancer compared to whites, but May noted that Hispanic people "have a rising incidence of young-onset disease, and the lowest screening rates."

"Among Asian Americans, screening rates are also 10% to 20% lower than among white Americans," she added.

Get screened

There's one surefire way to lower your odds of becoming a young victim of colorectal cancer: Follow recommended screening guidelines.

Colon cancer screening can involve tests based on stool samples, or a more invasive sigmoidoscopy or colonoscopy.

Screening is especially important if you carry certain genes predisposing you to colon cancer, May said, and everyone must find out "whether or not they have a family history of colorectal cancer."

"Nearly 30% of colorectal cancer diagnoses in people under age 50 are related to an underlying family history or genetic mutation, according to the American Cancer Society," May noted. "People with a father, mother, brother or sister who have had colorectal cancer must talk to their doctor about getting screened at age 40 or earlier."

Even without such a family history, you "must start regular screenings at age 45," she stressed. "This is a relatively new recommendation from the U.S. Preventive Services Task Force -- that screening for colorectal cancer should begin at age 45 rather than age 50. Unfortunately, many young people are not taking advantage of lifesaving screening technologies."

Fostering awareness among minority patients is crucial.

"Colorectal screening must be made a priority in these populations, access to screening tests needs to be expanded, and everyone must get screened," May said.

Watch for symptoms

Most importantly, don't ignore the symptoms of colorectal cancer.

Tragically, May said that she has "found that a lot of my younger patients who are dying from colorectal cancer have had symptoms for a year or two before they finally make an appointment. And by the time they get a colonoscopy, their cancer is advanced to stage four. Survival for stage four is very low -- only 13%."

The major signs of colorectal cancer are "red or black blood in the stool, losing weight without trying, or a change in bowel habits that lasts more than a few days," May said.

Again, screening is crucial if symptoms arise.

"It's estimated that more than half of colorectal cancer deaths could be prevented by early detection through screening -- and that's just not happening," May said. "People need to start screening early and continue to have it done regularly throughout their lives."

SOURCE: UCLA Health, news release, Feb. 20, 2024

What This Means for You:

Colon cancer is hitting Americans under 50 in rising numbers; know your risk factors and get screened, one expert says.

Race Cancer: Colon