Early-onset colorectal cancer manifests through several distressing symptoms, including persistent stomach pain, chronic diarrhea, rectal bleeding, and anemia. Alarmingly, research over the past two decades reveals a staggering increase in cases among younger populations. Specifically, the incidence of colorectal cancer has surged by 500 percent among tweens and has more than tripled among teenagers.
Key Points to Note:
- Increasing Diagnosis Among Youth: Each year, hundreds of thousands of children aged 10 to 19 are being diagnosed with colorectal cancer. This demographic, once considered low-risk, is now experiencing a significant rise in cases.
- Rising Incidence in Young Adults: The trend is not limited to adolescents. Adults aged 20 to 44 are also seeing a notable increase in colorectal cancer diagnoses, suggesting a broader age range is affected by this troubling trend.
- Uncertain Causes: While the precise reasons for the uptick in early-onset colorectal cancer remain unclear, experts speculate that a combination of genetics, dietary habits, and lifestyle factors may contribute to the heightened risk among young people. Further research is needed to identify specific causes and develop effective prevention strategies.
Colorectal cancer has traditionally been regarded as a disease affecting older adults. However, a recent study reveals a significant surge in cases among younger populations, including children, teenagers, and young adults, over the last twenty years. The findings, set to be presented at Digestive Disease Week, an international conference for gastroenterology professionals, indicate a staggering 500 percent increase in colon cancer diagnoses among children aged 10 to 14 from 1999 to 2020. During the same period, teens aged 15 to 19 experienced a 333 percent rise in cases, and young adults aged 20 to 24 saw an increase of 185 percent.
“Our findings were unexpected, given the historical perception of colorectal cancer as primarily affecting older individuals,” lead researcher Islam Mohamed, MD, an internal medicine resident physician at the University of Missouri in Kansas City, said. “The notable percentage change is alarming, signaling a need to address and mitigate this trend.”
Small Number of Actual Colon Cancer Cases in Kids
While the percentage increases were notably high, Dr. Mohamed emphasizes that the actual number of new diagnoses remains relatively low, with nearly 90 percent of all colorectal cancer cases still occurring in individuals aged 50 and older.
An analysis of data from the Centers for Disease Control and Prevention (CDC) reveals the following increases in colon cancer diagnoses between 1999 and 2020:
– Among children aged 10 to 14, cases rose from 0.1 to 0.6 per 100,000 children.
– Among teenagers aged 15 to 18, cases increased from 0.3 to 1.3 per 100,000 teenagers.
– Among young adults aged 20 to 24, cases grew from 0.7 to 2.0 per 100,000 individuals.
Despite the small percentages, these figures represent hundreds of thousands of colon cancer cases among children and young adults annually. Dr. Mohamed notes that, while the risk is comparatively low, especially when compared to the most common types of cancers in these age groups, the trend is concerning. For instance, the National Cancer Institute reports that, in 2021, the rate of new leukemia cases among children aged 0 to 19 was 4.8 per 100,000, and the rate of new brain cancer cases was 3.0 per 100,000 children per year.
The increase in colorectal cancer among younger populations underscores the importance of early detection and awareness. While the overall risk remains low, the rising trend calls for more research into potential causes, as well as efforts to develop strategies for prevention and early intervention.
Experts Worried About Early-Onset Colorectal Cancer Cases
Still, many health experts see this trend to be a cause for concern.
“When I first started practice 30 years ago, there was literally nobody under the age of 50 with colon cancer — now flash forward a few decades and half my clinic is under the age of 50,” John Marshall, MD, chief medical consultant of the Colorectal Cancer Alliance and director of the Ruesch Center for the Cure of Gastrointestinal Cancers at Georgetown University in Washington, DC, stated. “That’s a phenomenon we’re not only seeing here in Washington, DC, but also nationwide and even worldwide.”
In response to the increasing incidence of colorectal cancer among individuals under 50, the U.S. Preventive Services Task Force updated its guidelines in 2021, lowering the recommended age for initial screening from 50 to 45 for adults at average risk.
Signs of Colorectal Cancer in Children and Teens
The study authors emphasize that the incidence of colorectal cancer among children and teenagers is not yet high enough to recommend routine colonoscopy screenings for these age groups. However, screenings may be necessary if young individuals exhibit symptoms of cancer.
“Recognizing symptoms of colorectal cancer is so important to stimulate screening for earlier stage of diagnosis for a better outcome,” Cathy Eng, MD, director of the Young Adults Cancers Program at the Vanderbilt-Ingram Cancer Center in Nashville, Tennessee, and a board member with Fight Colorectal Cancer, said. If spotted in its early stages, this type of cancer is highly treatable and reduces the need to seek out the aggressive form of therapy.
Research published last year identified four key warning signs to watch for: abdominal pain, rectal bleeding, diarrhea, and iron deficiency anemia.
Experiencing just one of these symptoms nearly doubled the likelihood of being diagnosed with early-onset colorectal cancer compared to having none. The presence of three or more symptoms was associated with a sixfold increase in risk.
“If you have symptoms, don’t delay an evaluation,” Dr. Eng said. “It could be your life or your child’s life at stake.”
Causes of Early-Onset Cancer Remain Unknown
At this stage, what’s fueling the increase in cancer at younger ages remains to be relatively unknown. Dr. Marshall finds the trend quite baffling because many of those diagnosed at his clinic have been considered to be physically fit. “We don’t actually know the answer to what’s going on,” he said.
The study authors have pinpointed several factors that may increase the likelihood of developing colorectal cancer. A family history of inflammatory bowel disease or colorectal cancer significantly raises the risk. Additionally, certain modifiable habits are linked to a higher risk, such as smoking, alcohol consumption, and a diet low in fiber but high in fats, processed meats, and sugar-sweetened beverages.
Moreover, inadequate physical activity, obesity, and the presence of tumor-promoting bacteria are also identified as potential contributors to colorectal cancer risk. Dr. Mohamed and his colleagues highlight that antibiotic use and food additives could further elevate the risk. These findings underscore the importance of both genetic awareness and lifestyle choices in managing and potentially reducing the incidence of colorectal cancer.
Middle-Aged Adults Facing a Higher Risk of Early-Onset Colorectal Cancer
Although the most striking percentage increases in colorectal cancer occurred among younger individuals, cases are also rising among middle-aged adults. Over the past two decades, the incidence of colon cancer among adults aged 30 to 34 increased by 71 percent, reaching 6.5 cases per 100,000 people. For those aged 35 to 39, the rate rose by 58 percent, to 11.7 cases per 100,000.
While the 40 to 44 age group experienced a comparatively lower percentage increase of 37 percent, it had the highest case rate, with 20.0 cases per 100,000 people in 2020. (The study focused on individuals aged 10 to 44.)
These findings further support evidence that colon cancer is affecting people at earlier stages of life than in the past. The rising incidence among middle-aged adults, combined with the significant increases among younger populations, highlights a concerning trend that calls for heightened awareness, early detection, and proactive measures to address this growing public health issue.
“The trend that we are seeing in younger people is now extending even further down to a younger population, suggesting that whatever is causing this doesn’t take a lot of time to do its thing, so it increases the urgency for us to figure out what this problem is,” Marshall said.
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