March is Colon Cancer Awareness Month, and doctors and health advocates are sounding the alarm about a disturbing trend: More and more young Americans are being diagnosed with the disease. What’s more troubling is that many cases are at an advanced stage, which puzzles doctors.
The colon and rectum are part of the large intestine. Colon cancer, officially known as colorectal cancer (CRC), usually begins when a mutation occurs, causing abnormal cell growth. This can lead to the formation of colon polyps, which the Mayo Clinic defines as small clumps of cells that form on the lining of the colon. At first, these polyps may be benign, but over time they can become cancerous. It is known that this type of cancer mainly affects older people, but it is increasingly seen in young people around the world.
The alarming increase in colon cancer diagnoses among young people was highlighted in a recent report by the American Cancer Society. According to research, among Americans under the age of 55, rates have almost doubled, from 11% in 1995 to 20% in 2019. Some studies estimate that the disease could become the leading cause of cancer death in the United States in people aged 20 to 49. by 2040.
But what is even more concerning for doctors is that late-stage diagnoses in young patients are also increasing significantly. According to the report, “60% of all new cases were advanced in 2019 compared to 52% in the mid-2000s”.
To better understand why this is happening, Yahoo News spoke with Dr. Marios Giannakis, medical oncologist and clinical researcher at Young-Onset Colorectal Cancer Center, part of the Dana-Farber Cancer Institute in Boston. The center provides care for patients with early colon cancer and also conducts multidisciplinary research to better understand the disease, as well as to develop ways to prevent, detect and treat it.
Why is colon cancer in young people on the rise?
“This early-onset colorectal cancer epidemic is still fairly recent and still largely unexplained,” Giannakis told Yahoo News.
He explained that early CRC has unique characteristics. It tends to be more aggressive and often presents on the left side of the colon rather than the right, and some patients with this type of cancer experience abdominal pain or rectal bleeding. However, he noted that many patients may not have any symptoms.
Why CRC cases in people under 50 are on the rise is a puzzling question that remains unanswered, and one, Giannakis said, which highlights the need for continued research. But there are a few clues as to why this may be happening.
Experts believe lifestyle risk factors may be contributing to higher rates of early CRC. Young Americans are experiencing higher rates of obesity and leading more sedentary lives. According to experts, they also consume greater amounts of processed and sugary foods. All of these factors are known to increase the risk of developing colon cancer.
According to the American Cancer Society, 55% of all CRCs are related to lifestyle factors. However, the organization notes that the biggest risk factor for developing the disease is having a family history.
Environmental exposures have also been associated with early-onset CRC, Giannakis said.
“One of the reflections following the epidemiological trends of this phenomenon that’s really been happening since the 90s…is what’s called the birth cohort effect,” he said. “It basically means that a risk factor or perhaps a combination of risk factors in the environment is perpetuated in younger generations because younger generations are simply more exposed to it,” he added.
But Giannakis said lifestyle and environmental factors don’t tell the whole story.
“There could be other things that we don’t quite understand about the molecular types of cancers, the cancers themselves, but also the microenvironment. of cancer, (or) what surrounds these early tumours,” he said.
The study of the microbiome – a community of microorganisms, primarily bacteria, found throughout the human body, particularly in the gut – is one of the research areas Giannakis’ team is focusing on. He said one question they hope to answer is “if the microbiome in our gut changes in a way that facilitates colon cancer.”
According to the Dana-Farber Cancer Institute, recent studies have shown that these bacteria may play a role in the development of CRCs and also in their response to treatment.
In a new paper published in Science, co-authored by Giannakis, researchers at the Dana-Farber Cancer Institute outlined the type of studies needed to better understand the underlying causes and biology of early-onset CRC. This research, the authors noted, should look at a combination of factors such as genetics, environmental and lifestyle factors, people’s immune systems and the environment in which these cancers develop.
Where in the United States are the most young people being diagnosed with colon cancer?
A recent study from the Cleveland Clinic provides insight into where early-onset CRC cases and deaths appear to be more common in the United States
“Among the younger patients, we found notable hot spots in the Midwest and also in the Great Lakes region,” Blake Buchalter, a Cleveland Clinic researcher and lead study author, said in a statement. In addition to finding these hotspots, the team of researchers located three places where early-onset colon cancer is less common: the Southwest, California and the Mountain West region.
The researchers said it’s not clear why colon cancer in young people is more common in some parts of the country, but they plan to investigate further to find answers.
But we know who in the population is most at risk. Based on new data from the American Cancer Society, three groups of the American population – American Indians, Alaska Natives and Black Americans – are disproportionately affected by the disease, having the highest rate. highest in diagnoses and deaths of any group in the country.
How can people reduce their risk of colon cancer?
The Centers for Disease Control and Prevention say the most effective way to reduce the risk of colon cancer is to get screened regularly. The age at which someone at average risk should get tested was lowered in 2021 from 50 to 45. However, some people, such as those with a family history of CRC and black Americans, should consider getting it sooner. The American College of Physicians recommends that black men and women get their first screening at age 40.
The gold standard for colon cancer screening, Giannakis said, is a colonoscopy. The test can visualize where polyps are in the colon, and doctors can remove most of them and some cancers during the procedure. However, most people under the age of 45 are not eligible for colonoscopies, so experts believe there may be a need to lower the screening age in the future to be able to catch cancers in people. in their twenties or thirties.
Besides colonoscopy, there are other types of screening tests available in the United States. The CDC recommends consulting a doctor to determine which one is right for you.
To reduce your risk of developing CRC, the agency recommends a healthy diet “low in animal fat and high in fruits, vegetables and whole grains”. Increasing physical activity, maintaining a healthy weight, and reducing alcohol consumption and smoking can also reduce the risk of developing this type of cancer.
Finally, Giannakis said young people shouldn’t ignore the symptoms associated with the disease. These can include changes in bowel habits, blood in the stool, abdominal pain, and weight loss.
“It’s important to listen to our body when symptoms suggestive of cancer appear, even at a young age. However, knowing that many of these cancers are asymptomatic, we should also be faithful to screening and pursue this,” he said.