Rising colorectal cancer rates among younger people call for earlier screening
Too young for colorectal cancer? Think again.
Colorectal cancer remains the third most common cancer, and the third most common cause of cancer death in the United States. But the demographic of who commonly gets it has changed.
Cases of colorectal cancer have steadily declined in men and women over age 65. But in people under age 55, the rate of diagnosis almost doubled — from about 11% in 1995 to 20% in 2019. The highest rates of colorectal cancer in the U.S. are seen among African Americans and Native Americans.
The disease, which can be easily prevented or treated in its early stages, is more frequently diagnosed in its late stages, when treatment can be more complex, says Radhika Smith, MD, Washington University colorectal surgeon at Barnes-Jewish Hospital.
While it’s unclear what’s driving these trends, doctors say that lifestyle factors — smoking, alcohol consumption, a sedentary lifestyle and eating a diet high in red and processed meat — can raise the risk of colorectal cancer.
The troubling rise of colon cancer in younger adults led the U.S. Preventive Task Force in 2021 to lower the recommended screening age for colorectal cancer from age 50 to age 45. Doctors recommend that all Americans be vigilant and have regular colorectal cancer screenings.
According to Dr. Smith, who also treats patients at Siteman Cancer Center, screenings are important because:
Colon cancer is often symptomless until it becomes more advanced and harder to treat.
They can detect cancer in its earliest stages when it can be more easily treated or cured.
Most colorectal cancers in the U.S. are diagnosed by screening colonoscopies, which can even prevent cancer by removing premalignant polyps.
The Preventive Task Force recommendations also affect what health insurance will pay for, which is good news for younger people wondering if their screening will be covered, says Dr. Smith.
There are five colorectal screening tests commonly available:
Fecal occult blood test, which tests samples of stool blood that is not visible to the eye.
Stool DNA test, which looks for both abnormal DNA and blood in stool.
Sigmoidoscopy, in which the doctor uses a small, flexible, lighted tube to inspect the rectum and up to 25 inches of the lower bowel.
Colonoscopy, where the doctor inspects the entire colon with a long instrument. The patient is typically sedated for the procedure.
Barium enema with air contrast examination. For this exam, the patient has an enema with barium sulfate, a chalky substance that shows up on X-rays. The doctor then X-rays the colon to look for tumors or abnormalities.
While it’s important to regularly schedule colorectal cancer screenings, be on the lookout for suspicious symptoms. These can include persistent changes in bowel habits, such as constipation or diarrhea; rectal bleeding or visible blood in the stool; narrowed stools; persistent abdominal pain, cramps or bloating; or feeling that the bowel isn’t fully emptying. If you have any of these symptoms, talk to your doctor immediately.
Get more information on colorectal cancer screening across BJC: