Rising Colorectal Cancer Rates in Young People

The Colorectal Cancer Statistics 2023, released by the American Cancer Society, suggests colorectal cancer cases in people under 55 are rising, while advanced-stage colorectal cancer diagnoses are also increasing.

Colorectal cancer is the second most common cause of cancer-related death in the United States and the leading cause of cancer in males younger than 50. However, more than half of all colorectal cancer diagnoses are likely caused by modifiable risk factors such as smoking, high alcohol consumption, a poor diet, obesity, and lack of physical activity.

To monitor and track the disease, the American Cancer Society releases updated statistics on the incidence and mortality rates of colorectal cancer every three years.

This year's report, published on March 1 in CA: A Cancer Journal for Clinicians, along with a consumer-friendly version, Colorectal Cancer Facts & Figures 2023-2025, showed several key findings related to colorectal cancer rates in the U.S.

According to the statistics, the researchers estimate that in 2023, 153,020 new cases of colorectal cancer will be diagnosed in the U.S., and there will be 52,550 disease-related deaths. Moreover, the data indicates that men may be more at risk than women, as men had a 33% higher rate of this type of cancer than women from 2015–2019.

Higher rates of colorectal cancer also occurred in Alaska Native people, Native Americans, and Black people. Moreover, incidences of colorectal cancer were higher in parts of the South, Midwest, and Appalachian regions and lowest in the Western part of the U.S.

In addition, colorectal cancer diagnoses nearly doubled from 1995 to 2019 in people younger than 55. In 1995, about one in 10 people in that age group were diagnosed with colorectal cancer — in 2019, that number was one in 20.

The data also showed shifts in the number of people diagnosed with advanced-stage colorectal cancer. For example, in the mid-2000s, the percentage of people diagnosed with regional or distant stage cancer was around 52%. However, in 2019, 60% were late-stage diagnoses.

Still, death rates from this type of cancer fell by 2% to 3% annually for all racial groups. Moreover, up-to-date screening for colorectal cancer reached 59% in 2021 among people 45 years and older.

Since 2018, the American Cancer Society has advised everyone in this age group to undergo screening with one of the recommended screening tests. These include colonoscopy, computed tomographic colonography (CTC) scans, flexible sigmoidoscopy, and stool tests such as fecal immunochemical test (FIT), high-sensitivity guaiac-based fecal occult blood test (gFOBT), and FIT-DNA test (Cologuard®).

Still, colonoscopy is considered the gold standard as it can identify and remove polyps — although the procedure is more invasive than other screening methods.

In a news release, the report’s lead author Rebecca Siegel, senior scientific director and surveillance research at the American Cancer Society, says, "We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population. The trend toward more advanced disease in people of all ages is also surprising and should motivate everyone 45 and older to get screened."

To help ensure all people have access to colorectal screening, in November 2022, the Centers for Medicare and Medicaid Services (CMS) finalized a Medicare rule that allows coverage of colonoscopies after a person uses a non-invasive screening test. The rule also lowered the minimum age for screening to 45.

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