Colon Cancer Stalks Younger Patients
Experts aren't sure why, but are recommending earlier screenings and healthier lifestyles.
Many people think of cancer as a disease of old age, but that’s often not the case. One glaring exception is colorectal cancer, a cancer that starts in the colon or the rectum. According to the American Cancer Society, colorectal cancers can also be referred to as colon or rectal cancer, depending on the origin. The two are often grouped together because they share many features.
The ACS reported in 2017 that new cases of colon cancer and rectal cancer are occurring at an increasing rate among young and middle-aged adults. People born in 1990 have double the risk of colon cancer and quadruple the risk of rectal cancer compared to those born around 1950, the ACS said.
JAMA Surgery, which is published by the American Medical Association, has reported that by 2030, the incidence and mortality rates for colon and rectal cancers will increase by 90 percent and 124 percent, respectively, for patients ages 20 to 34. These trends are impacting Kansas City area physicians’ practices.
“Unfortunately, we are seeing younger and younger patients coming to our clinics with colon and rectal cancers at varying stages of diagnosis,” says Dr. Raed Al-Rajabi, a medical oncologist with the University of Kansas Cancer Center.
Dr. Alka Hudson, a gastroenterologist who practices with WestGlen Gastrointestinal Consultants in Shawnee, says she, too, is encountering more young adults with colorectal cancer. “And they are more likely to be diagnosed with later stage disease,” she adds.
So why is this happening? No one knows for sure, but there are concurrent trends that may be related. One thing we’ve noticed that has been on the rise in conjunction with colon cancer is obesity,” Al-Rajabi says. “We’re not sure if that’s also a risk factor in developing this disease.” Other possible factors include greater consumption of red meat, as well as prolonged use of antibiotics in adulthood, Hudson says.
The ACS says you can lower your risk of colorectal cancer by:
• Eating lots of vegetables, fruits and whole grains and less red or processed meat.
• Getting regular exercise.
• Watching your weight.
• Avoiding tobacco.
• Limiting alcohol consumption.
In addition to such preventive measures, the ACS says young adults should be alert to signs and symptoms of colorectal cancer such as:
• A change in bowel habits that lasts for more than a few days.
• A feeling that you need to have a bowel movement that is not relieved by doing so.
• Rectal bleeding.
• Dark stools or blood in the stool.
• Cramping or abdominal pain.
• Weakness and fatigue.
“If you’re having symptoms, you’ve got to go in and talk to your doctor,” Hudson says.
Catching colorectal cancer at an early stage is crucial to surviving the disease. In May 2018, the ACS recommended that colorectal cancer screenings for those at average risk begin at age 45, down from the previously recommended age of 50. The new ACS guideline says people at higher-than-average risk for colorectal cancer, such as those with a strong family history of the disease, might need to start screening before age 45 and be screened more often.
One of the most widely used colorectal screening tests is the colonoscopy, which is recommended every 10 years after the initial test. Hudson says she has been recommending more of these to her younger patients who exhibit symptoms.
“Before, when they would come in with symptoms like bleeding, most of the time we’d say it’s probably hemorrhoids and try some hemorrhoid cream,” she says. “If that didn’t work, we’d do a colonoscopy. But now, because of these studies, I offer people colonoscopies when they come in bleeding.”
Becky Buseman, a 26-year-old Overland Park resident, underwent regular colonoscopies for most of her life because she suffered from ulcerative colitis, an inflammatory bowel disease that increases the risk of colorectal cancer.
A colonoscopy in 2015 revealed that Buseman had colon cancer. Her treatments included colon removal surgery and chemotherapy.
“I’m doing really well right now health-wise,” says Buseman, who earned a bachelor’s degree in marketing from Kansas State University and is looking for a marketing job in health care.
Some patients cringe at the thought of colonoscopies because of the preparation that cleans out one’s bowels. Or maybe they don’t want to undergo any test that could deliver bad news. But Buseman says colonoscopies should not be avoided, especially if you’re at higher-than-average risk for colorectal cancer.
“It’s not that bad,” she says. “If finding something is scary to you, it’s a lot worse to not find something and have something bad happen to you. Just get checked. Take care of yourself. And if you do find something, then you’ll get through it.”