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Demographic Shifts in Colorectal Cancer: Implications for Younger Adults



Colorectal cancer poses a significant threat, especially to younger adults. It's the deadliest cancer for men under 50 and the second deadliest for women in the same age group, just after breast cancer. Over the past two decades, the number of cases has been increasing steadily. It used to be the fourth-leading cause of cancer-related deaths among people under 50, but now it's on the rise. That's why young adults need to pay attention to any unusual signs like constipation, rectal bleeding, or sudden changes in bowel habits and talk to their doctors about them. Early detection and treatment can make a big difference in beating this cancer.


Table 1. Trend of colorectal cancer rates from 2000-2020 in US adults under 50 years old.

The rates are calculated per 100,000 people and adjusted for age based on the 2000 US standard population for cases of localized disease.

Source: SEER Incidence Data, Submission as of November 2022 (Covering the years 1975-2020).


What is Colorectal Cancer?

Colorectal cancer is a malignancy originating in the tissues of the colon or rectum, which are important components of the gastrointestinal tract responsible for digestion and waste elimination. It arises from the abnormal growth and rapid increase of cells within the colon or rectal mucosa (inner lining of the colon and rectum), leading to the formation of malignant tumors.


Why is there an uptick in young adults getting colorectal cancer?

The reasons behind the rise in colorectal cancer cases among young people remain a bit of a mystery. However, certain lifestyle factors seem to play a role. Things like not getting enough exercise, being overweight or obese, smoking, drinking heavily, and eating diets low in fiber but high in fat or processed meats have all been linked to higher risks of developing colorectal cancer. Additionally, having a family history of colorectal cancer or certain bowel conditions like inflammatory bowel disease can increase your risk too.

A study involving nearly half a million people, published in the International Journal of Epidemiology, found some interesting connections. It showed that folks who ate red or processed meat four or more times a week had a 20% higher chance of getting colorectal cancer compared to those who ate less than twice a week. Eating processed meat every day, like a slice of ham, raised the risk by 19%. And for every thick slice of roast beef (about 50 grams) eaten daily, the risk went up by 18%. Even having just half a pint of beer each day was linked to an 8% higher risk of colon cancer.


How can I stay healthy? If you experience any of the following symptoms, it's important to talk to your doctor:


  • Rectal Bleeding: Keep an eye out for blood in your stool, in the toilet after a bowel movement, or coming from the rectum.

  • Changes in Stool: Pay attention to any unusual changes in the appearance of your stool. Dark or black stools might indicate bleeding from a tumor. Also, be mindful of narrow, thin, or ribbon-like stools, which could signal a blockage in your bowels or rectum.

  • Changes in Bowel Movements: Notice any changes in your bowel habits, such as diarrhea or constipation (having less than three bowel movements a week), especially if they persist for two weeks or more.

  • Low Energy or Fatigue: Chronic tiredness could be a sign of anemia caused by blood loss. If you're a young woman experiencing persistent anemia that you attribute to menstrual bleeding, it's a good idea to consider other potential causes as well.

Being aware of these symptoms and communicating with your doctor can help ensure early detection and proper management of any underlying health issues. Your well-being is important, so don't hesitate to seek medical advice if you have concerns about your health.


To reduce your risk of colorectal cancer, consider implementing the following lifestyle changes:

  • Quit Smoking: This includes e-cigarettes. Smoking not only increases your risk of lung cancer but also colorectal cancer and other types of cancer.

  • Drink Responsibly: The American Cancer Society recommends limiting alcohol intake to no more than two drinks per day for men and one drink per day for women.

  • Stay Active: Leading a sedentary lifestyle is associated with a higher risk of developing colorectal cancer. Incorporating regular exercise into your routine may help lower your risk.

  • Maintain a Healthy Weight: Being overweight or obese significantly increases the risk of both developing colorectal cancer and experiencing adverse outcomes. This is particularly true for colon cancer.

  • Increase Fiber Intake: Aim to consume around 25 grams of fiber per day to support a healthy colon. This can be achieved by incorporating more fresh fruits, vegetables, whole grains, beans, and legumes into your diet. The average American diet typically contains only 10 to 15 grams of fiber per day.

By making these lifestyle adjustments, you can take proactive steps to promote colorectal health and reduce your risk of developing colorectal cancer.



Colonoscopy Screening

When it comes to screening for colon cancer, colonoscopy is the top choice. This method lets your doctor check out the inside of your colon directly. If they find that there are any suspicious growths (polyps) during the procedure, they can remove them right then and there, potentially preventing cancer from developing.


While there are other screening tests available that look for cancer DNA or blood in your poop, they're not always the best fit for everyone, especially if you're at higher risk.


Getting a colonoscopy is a standard procedure that doctors have been performing for years. Before the actual colonoscopy, you'll need to follow a special liquid diet to prep your colon. When you're at the doctor's office, they'll give you anesthesia to make you comfortable, and you'll likely have no memory of the procedure afterward.


During the colonoscopy, your doctor will use a thin, flexible tube with a light and a camera on the end to explore your colon. They might also use tools to remove tiny bits of tissue for testing.


If you're experiencing symptoms of colorectal cancer, don't hesitate to speak up and ask for a screening, even if you're not in the typical age range recommended for screening. Your health matters and early detection can make a big difference!


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