Colorectal cancer has long been considered an illness that primarily affects older adults. With more than 90% of cases occurring in people age 50 and older, young people are often unaware they, too, should take note of their cancer risks.
However, according to the American Cancer Society (ACS), approximately 50 people under age 50 are diagnosed with colorectal cancer every day in the U.S. In 2020, this age group accounted for approximately 12% of colorectal cancer cases, nearly double the number of cases in young people in the 1990s. What’s more, younger people are more likely to be diagnosed with late-stage colon or rectal cancer than older people.
The cancer risks you cannot change
While causes for the increase in colorectal cancer cases in younger adults are still being investigated, advanced cancer diagnoses in people under age 50 are commonly due to the lack of screening for this age group. Newer guidelines from the ACS and gastroenterology societies now recommend that patients thought to be at average risk for colorectal cancer begin screening at 45 years old. Patients in this age group should reach out to their doctor to discuss screening options.
“People who have health conditions such as inflammatory bowel disease, known as IBD, including ulcerative colitis or Crohn’s disease, are at increased risk for colorectal cancer or polyps,” says Dr. Ana Crissien, a board-certified gastroenterologist with Sharp Rees-Stealy Medical Group. “People with these conditions are typically under the care of gastroenterologists and following recommendations about disease management and screening to help prevent colon cancer.”
Additionally, the U.S. Multi-Society Task Force on Colorectal Cancer recommends that people with a family history of colorectal cancer receive their first screening at age 40 or 10 years before the age when their first-degree relative was diagnosed with colorectal cancer. They are also encouraged to be screened more frequently than those with average risk.
The signs, symptoms and risk factors you can change
The best protection against developing colorectal cancer is knowing the signs and symptoms and recognizing the role that lifestyle choices play.
The ACS reports that colorectal cancer often does not cause recognizable symptoms in its early stages. But attention should be paid to the following:
- Changes in bowel habits that last for longer than a few days
- Rectal bleeding
- Blood in the stool
- Cramping or stomach pain
- Weakness and fatigue
- Unintended weight loss
Of equal importance is recognizing the colorectal cancer risk factors that can be changed. According to Dr. Crissien, these include:
- Being overweight or obese
- Not being physically active
- Consuming a diet that is high in fat, red meat and processed meat, and low in fiber
- Drinking too much alcohol
- Smoking
“Colon cancer is preventable,” she says. “Prevention measures such as maintaining a healthy weight, getting regular exercise, minimizing alcohol use, avoiding smoking and following a diet that’s high in fiber, and low in fat and processed and red meat, helps,” Dr. Crissien says.
The importance of regular screening
However, the best advice Dr. Crissien offers is to get screened. In the U.S., individuals at average risk for colorectal cancer should have their initial colorectal cancer screening by age 50, and by age 45 for Black adults. Intervals for subsequent screenings depend on the findings of the initial test. People should talk with their doctor about whether their personal risk factors — both the lifestyle choices that can be changed and the risk factors that cannot — may call for earlier or more frequent screening.
“Colorectal cancer can only be prevented, or found early, if we look for it,” Dr. Crissien says. “Talk with your doctor about your family and personal history to determine if you are at higher risk. I also recommend that you do not delay scheduling screening exams, and continue to schedule regular follow-up colonoscopies.”