Young Adults and Colon Cancer: Rising Trends

The rate of colon/colorectal cancer diagnosis in young adults is on the rise, particularly in people younger than 50 years old. Different research studies are currently exploring the reasons for this unusual rise. There is an urgent need to increase awareness of developing colorectal cancer and to increase the rates of early detection.

What is colon cancer?

The colon is the largest part of the large intestine. According to the National Cancer Institute, colon cancer is a cancer that develops in the colon. Colon cancer is related to colorectal cancer, but they are not exactly the same.

It should be noted that while all colon cancers are colorectal cancers, not all colorectal cancers are confined to the colon; they can also occur in the rectum (i.e., rectal cancer). Hence, colorectal cancer encompasses cancers that occur in the colon and the rectum.

Statistics and trends

Colorectal cancer is currently the leading cause of death in people assigned male at birth under the age of 50, and the second leading cause of death in people assigned female at birth in that same age group.

Researchers at Digestive Disease Week in May 2024 discovered that from 1999 to 2020, the rate of colorectal cancer rose 500% among children ages 10–15, 333% among teens aged 15–19, and 185% among people ages 20–24.

There is an urgent need to increase public awareness of the signs and symptoms of colorectal cancer in adults in their 20s.

Symptoms of colon cancer in young adults

There are common symptoms of colorectal cancer in young adults, particularly in those with early onset colorectal cancer.

Some young onset colorectal cancer symptoms or warning signs include the following:

• Abdominal pain
• Rectal bleeding
• Diarrhea
• Iron deficiency anemia
• Fatigue and weakness

A case-control study involving 5,075 early onset colorectal patients aged 18–64 years identified the first four signs and symptoms listed above as red flag signs and symptoms.

There are subtle symptoms of early onset colon cancer that might be ignored. These are symptoms like changes in bowel movements (such as persistent diarrhea or narrower stools than usual), weight loss, and gas/bloating.

Causes and risk factors

Risk factors are different causes that increase the chances of getting a disease or condition. There are different risk factors for colon cancer.

• Genetic factors. Family history and inherited syndromes can contribute to colon cancer. 5–10% of colon cancer is hereditary. Lynch syndrome (previously known as Hereditary Non-Polyposis Colorectal Cancer or HNPCC) and Familial Adenomatous Polyposis are known key hereditary colon cancer syndrome.
• Lifestyle and environmental factors. Some of these factors include a poor diet, smoking, excessive alcohol consumption, an inactive lifestyle, being obese or overweight, and being exposed to ionizing radiation.
• Other potential causes. Health conditions such as inflammatory bowel disease and type 2 diabetes could be risk factors for colon cancer.

Why colon cancer is increasing in young adults

There are several potential factors contributing to the observed increase in colon cancer diagnoses among younger adults, most of which are mainly linked to the adoption of modern lifestyle habits Some of these factors include changes in lifestyle and diet, environmental exposures, and improved detection methods.

Changes in lifestyle and diet

Consuming excessive amounts of processed food and high-fat diets could be contributing factors to colon cancer. The modern Western diet is high in processed meats, fast food, and sugary snacks, all of which may contribute to inflammation and increased colorectal cancer cases.

Since 202, working from home has become a new normal. With more young adults working from home, there is a higher chance of developing a sedentary lifestyle. The lack of exercise increases the risk of colon cancer.

Environmental exposures

Possible environmental causes contributing to the rise in colorectal cancer cases in younger adults include increased alcohol consumption and alterations in gut microbiota/gut bacteria due to diet, antibiotics, and other medications.

Improved detection methods

Improved methods to detect the warning signs of colon cancer could positively influence the alarming trend associated with the disease. Adenomas and precancerous polyps are precursors to colorectal cancer; if they are not detected and treated early, they can develop into colon cancer.

New research reveals the benefits of improved detection methods. A 2022 study found that the GI Genius technology — a new tool for detecting colon cancer — reduced the rate of missed adenomas and polyps by 45.8%.

Diagnosis and screening

Early diagnosis and screening for colon and rectal cancers is essential to improve their outcomes.

The American Cancer Society recommends seeking medical attention if you experience any of the symptoms listed below.

• A change in bowel movement (e.g., constipation, diarrhea, or narrowed stools) that persists for longer than a few days
• Rectal bleeding with bright red blood
• Weight loss without trying

Common diagnostic tests

There are different screening and diagnostic tests. Some of the common ones are listed below:

• Colonoscopy. A colonoscope (a flexible tube with a camera) is inserted through the rectum to examine the colon and rectum.
• Fecal occult blood test. This is a stool test that detects any blood that is hidden in the stool.
• Computed tomography colonography. This is a scan of the abdomen and pelvis to produce detailed images of the colon and rectum.

The early diagnosis and treatment of colorectal cancers can have different benefits. These include improved survival rates, reduced risk of disease complications, and the use of less aggressive treatment.

Treatment options

Thanks to modern technology and advancing research, we now have different treatment options for colon and rectal cancer, both surgical and non-surgical.

• Surgical treatments. Different types of surgeries are used to treat colon or colorectal cancers. The choice of procedure depends on the cancer's stage, location, and other factors. Colonoscopy with polypectomy is a surgery for early-stage cancers. Palliative surgery is typically recommended for advanced disease.
• Non-surgical treatments. Chemoradiotherapy, chemotherapy, and targeted therapy with certain medicines are examples of non-surgical treatments. Schisandrin B, a compound that is found in magnolia berries, may be effective in treating late-stage colon cancer as new emerging research suggests.

Targeted therapies are cancer treatments designed to target and attack cancer cells while preventing significant damage to normal, healthy cells.

Recent advancements in colon and rectal cancer treatment using targeted therapies have made a positive impact on patient outcomes by improving survival rates.

Prevention and lifestyle changes

There are some healthy lifestyle choices that could be adopted to prevent colorectal cancer in younger populations.

Avoid constantly eating highly processed food, excessive alcohol consumption, intake of sugary drinks and foods, high-sodium foods, and grilled meats. A healthy diet consisting of fruit and vegetables, whole grains, and lean proteins should be consumed and incorporated into a healthy lifestyle.

Studies show that regular physical activity reduces the risk of cancer incidence and mortality. Adopting a healthy lifestyle consisting of regular exercise could be beneficial in preventing the risk of colorectal cancer.

It also is crucial to undergo routine screenings. Early intervention could increase the likelihood of positive treatment outcomes.

People considered to be at average risk of colorectal cancer are recommended to start screening at the age of 45. However, people younger than 45 could consult their primary doctor to undergo screenings and check-ups, particularly if you suspect you may have symptoms.

Support and resources

Different support materials and resources are available for colon and rectal cancers. For instance:

1. The Colorectal Cancer Alliance recommends seeking emotional and mental health support by speaking with others about a diagnosis.
2. The American Cancer Society has various supportive online communities providing a wide array of resources for those affected by colorectal cancer.
3. The Colon Cancer Coalition is known to fund efforts to increase awareness and screening and to support colon cancer patients and their caregivers.
4. The Patient Advocate Foundation's Copay Relief Program provides financial support to eligible patients.
5. Family Reach provides financial support to patients and families affected by cancer.

There is a concerning rise in the rates of colorectal cancer diagnosis in young people. As a result, it is crucial to seek medical advice if you experience any symptoms of colon cancer in your 20s (such as a change in bowel habits, blood in stools, or unexplained weight loss). Early screening could increase the chances of early detection, which, in turn, increases the chances of positive treatment outcomes.