Haims: For people under 50, colorectal cancer is on the rise

Colorectal cancer is a cancer that starts in the colon (large intestine) or rectum. Often, it begins as abnormal growths called polyps develop within the lining of the colon and/or rectum. As polyps grow out of control, they turn cancerous over time. When caught early, CRC is highly treatable and curable. 

For decades, the American Cancer Society had recommended that men and women should start colorectal cancer screenings by the age of 50.  In 2018, the ACS reduced the recommended starting age to 45. Unfortunately, incidence rates for people under 50 are going up at an alarming rate. 

Researchers don’t know exactly why, but people as young as their 20’s and 30’s have been experiencing an unprecedented rise in colorectal cancer. An updated Yale Medicine article from last year stated, “In early 2023, the American Cancer Society (ACS) reported that 20% of diagnoses in 2019 were in patients under age 55, which is about double the rate in 1995, and rates of advanced disease increased by about 3% annually in people younger than 50.” 

It is unsettling that just 20-years ago, the ACS had rank colorectal cancer as the fourth leading cause of cancer death for those under the age of 50. Currently, the ACS ranks colorectal cancer as the first leading cause of cancer death in men and second for women.   

While researchers are not sure why such a dramatic shift has occurred, they do have ideas. Obesity is a major culprit. In 2000, adult obesity in the US was about 27.7%. In 2024, obesity in adults rose to 43.1%.  Obesity is so prevalent in the US that it has risen from 13.9% in 2000 to 21.1% in 2023 in persons aged 2 to 19 years old.  

In addition to obesity, unhealthy diets are suspected as another leading cause of colorectal cancer in young people. A Cleveland Clinic study publish in the publication, Nature has “identified diet-derived molecules called metabolites as main drivers of young-onset colorectal cancer risk, especially those associated with red and processed meat.” Especially in men, ultra-processed foods have been found to increase colorectal cancer. 

Not surprisingly, sedentary lifestyles, characterized by prolonged periods of sitting or inactivity, are also high on the list of habits linked to an increased risk of colon cancer. Sedentary lifestyles and a lack of physical activity promote excessive adiposity and therefore insulin resistance and chronic inflammation — both of which facilitate the process by which normal cells are transformed into colorectal cancer cells. 

Colorectal can grow slowly and have no symptoms in its early stages, so screening can find it when it is most treatable and curable. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread. 

The most prevalent signs of colorectal cancer are blood in the stool and persistent changes in bowel habits, such as diarrhea, constipation, or a feeling of incomplete emptying. Other key symptoms include unexplained weight loss, abdominal pain, or cramping that doesn’t go away, and fatigue, which can be a sign of anemia from chronic bleeding.

There are three main types of colorectal cancer screening tests: 

• Stool-based tests: These tests check the stool (feces) for signs of colon or rectal cancer, such as small amounts of blood. These tests are not invasive and are easier to have done than visual exams, but they need to be done more often. 
• Visual exams: These tests look inside the colon and rectum for any abnormal areas. They are done either with a Colonoscopy (scope that is placed into the rectum), or with special imaging tests called Virtual colonoscopy (a CT scanner).  
• Blood-based tests: These tests check for molecular biomarkers within a person’s blood for signs of colorectal cancer. 

As a society, we too often don’t recognize the importance of prevention. Instead, we continually experience regret after harms have happened upon us. We need to change our mindsets and become proactive. 

Regardless of which screen test you choose, don’t put it off!  Your life may depend upon it.  

Judson Haims is the owner of Visiting Angels Home Care in Eagle County. He is an advocate for our elderly and is available to answer questions. Connect with him at jhaims@visitingangels.com.