Steep Rise in Colorectal Cancer in Younger Patients

Highlights:

• Colorectal cancer has been on the rise, especially in individuals less than 50 years who often present with advanced disease (stage 3/4) at diagnosis
• Colorectal cancer is the third leading cause of cancer in the US, and the second most common cause of cancer death. It typically affects persons older than 50 years and affects all genders, races and ethnic groups
• The reasons for this are unclear and more research is the need of the hour to get answers so that preventive steps can be taken. In the meanwhile, the American Cancer Society has lowered the screening age for colorectal cancer to 45 years

Colorectal cancer has been on the rise especially in persons less than 50 years, often with advanced disease at diagnosis, according to a recent review of patient data from the National Cancer Database Registry which provides information on over 70 percent of new cancer cases in the United States. The study was undertaken by Boone Goodgame, MD, of The University of Texas at Austin, and his colleagues from the National Cancer Database registry and the study was published online in CANCER, a peer-reviewed journal of the American Cancer Society (ACS).

Analyzing Colorectal Cancer Trends

• The team reviewed patient data from 2004 to 2015 (which is the latest data available) of 130,165 patients under age 50 and 1,055,598 patients older than 50 years diagnosed with colorectal cancer The proportion of colorectal cancer cases under 50 years of age increased from 10% in 2004 to 12.2% in 2015
• The increase in colorectal cancer was more marked in younger patients of African American and Hispanic populations compared to non-Hispanic whites during the study period (2004-15)
• Proportion of patients less than 50 years with advanced cancer stage was higher (51.6%) compared to 40% among patients older than 50 years
• In men under 50 years diagnosis of colorectal increased only in non-Hispanic whites, while in women, both Hispanic and non-Hispanic whites showed an increased incidence
• Increased incidence of colorectal cancer in young adults was not influenced by socioeconomic status. The highest rates of colorectal cancer in younger patients were found to be in the top income category
• The increase in colorectal cancer incidence in younger persons was seen in urban areas but not in rural locations

Thus, the findings of the current study are similar to other studies demonstrating an increased incidence of advanced - stage colorectal cancer in younger patients.

Although the reasons remain unclear, Dr. Goodgame states that current research so far on the subject suggest that increased body weight and altered gut bacteria might be contributing factors for the rise in colorectal cancer in younger patients.

"Several studies have shown that the rates of colorectal cancer in younger adults have risen slowly in the US since the 1970s, but for practicing physicians, it feels like we are seeing more and more young people with colorectal cancer now than we were even 10 years ago," said Dr. Goodgame. "Until just last year, guidelines recommended colon cancer screening beginning at 50. Now many guidelines do recommend screening at age 45, but most physicians and patients don't appear to be following those recommendations."

Tips To Prevent Risk of Colorectal Cancer

• Follow a healthy diet and lifestyle
• Include plenty of fresh fruits and vegetables in the diet
• Avoid trans fats and junk food
• Reduce smoking and alcohol
• Exercise Reduces Colon Cancer Growth
• Persons 45 years and above should undergo regular screening with colonoscopy
• Persons with a family history of colorectal cancer should get screened at age 40 or a minimum of 10 years before the age when it occurred in a first-degree relative (parents and siblings)
• Early detection is key and consult your doctor if you have any suspicious symptoms

In summary, further research is needed to find out the reasons for the increasing incidence of colorectal cancer in younger patients. However, it is recommended to follow a healthy living, have regular screening and consult a doctor immediately should any abnormal symptoms occur.

References:

1. Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015 - (https://doi.org/10.1002/cncr.32347)
2. What Colorectal Cancer is, and where it starts - (https://www.ccalliance.org/colorectal-cancer-information/what-is-colorectal-cancer)

Source-Medindia