HEALTHY LIVING


Colorectal Cancer Rising in Younger Adults


Here’s how to spot the warning signs. :: BY CHRIS ILIADES, M.D.


A


bout 20% of colorectal cancers are diagnosed in people younger than 50, twice the number in 1995,


according to the American Cancer Society. Colorectal cancer is now the leading cause of cancer deaths in men under 50.


“The majority of


these patients are 40 to 49 years old, but it’s not uncommon to treat patients in their 30s for colorectal cancer,” says Sean J. Langenfeld, M.D.,


professor of surgery and chief of Colon and Rectal Surgery at the University of


Nebraska Medical Center in Omaha. Most colorectal cancers start in


a polyp that takes about 10 years to spread into the colon, so colorectal cancer screening is key to reducing deaths from these cancers. During a colonoscopy, a doctor can


take biopsies of any suspicious polyps for early diagnosis. “While screening was previously


started at age 50, the American Cancer Society and the U.S. Preventive Services Task Force both recommend that colorectal cancer screening begin at age 45,” explains Langenfeld. “When patients have a family


history of colorectal cancer, they often have to start even younger than that, and have screening more frequently.”


ARE YOU AT RISK? Smoking, drinking alcohol, a low-fi ber, high-fat diet, eating processed meats, obesity, and/or lack of exercise are risk factors that can be reduced, called


86 NEWSMAX MAXLIFE | SEPTEMBER 2023


reversible risk factors, but the biggest risk is genetic. “A family history of colorectal


polyps and/or cancer is a signifi cant risk factor, as well as smoking and morbid obesity. “However, I should point out that many young patients with colon cancer don’t have a


strong family history, so it’s important to be diligent,” he advises.


Higher-risk patients should undergo screening


colonoscopy. Average- risk patients are also excellent candidates for colonoscopy, which has the greatest ability


to identify and treat both


cancerous and precancerous lesions. Non-invasive tests are also available,


but they have lower sensitivity, especially for precancerous polyps.


You can’t change your genes but you can lower your risk of colorectal cancer with a healthy lifestyle.


“However, the cancer community is


in general agreement that the best test is whichever one the patient is willing to undergo, as all available tests are far superior to doing nothing,” says Langenfeld.


WHY YOUNGER MEN? The rise in colorectal cancer in younger men may be due to an increase in reversible risk factors.


It may also be due in part to doctors looking for and fi nding these cancers in younger-aged people. “Primary care doctors and


other physicians are quicker to order colonoscopies for young patients with rectal bleeding, whereas 10 to 20 years ago they may have dismissed it as hemorrhoids,”


says Langerfeld. “However, the increased incidence extends beyond this bias, and we honestly don’t fully understand why. It’s possible that obesity is playing a role as well.”


WARNING SIGNS Symptoms of colorectal cancer are variable, and depend on the tumor’s location and morphology. Common symptoms include rectal bleeding and a change in bowel habits and stool caliber. “For example, increasing


constipation or alternating constipation and diarrhea, and stool that is dark or black or unusually thin. Advanced lesions can cause blockage and pain,” he says.


LOWER YOUR RISK You can’t change your genes but you can lower your risk of colorectal cancer with a healthy lifestyle. “Smoking is by far the most


controllable risk factor for colorectal cancer. Obesity is more complex, but we do encourage weight loss when feasible. “Most of what determines a


patient’s risk of colorectal cancer is outside of his or her control, and so the greatest way to lower risk is to be aware of risk factors and comply with recommendations for cancer screening,” advises Langenfeld.


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