Report shows ‘troubling’ rise in colorectal cancer in US adults under 55

Estimated reading time: 7-8 minutes

ATLANTA – Adults across the United States are being diagnosed with colon and rectal cancer at younger ages, and now 1 in 5 new cases are among those in their early 50s or younger, according to the latest report on colorectal cancer from the American Cancer Society.

The report states that the proportion of colorectal cancer cases in adults under 55 has increased from 11% in 1995 to 20% in 2019. There also appears to be an overall shift towards more diagnoses of advanced stages of cancer. In 2019, 60% of all new colorectal cases among all ages were advanced.

“Anecdotally, it’s not uncommon for us to hear about a young person with advanced colorectal cancer,” said Dr. William Dahut, scientific director of the American Cancer Society. For example, Broadway actor Quentin Oliver Lee died last year at 34 after being diagnosed with stage IV colon cancer, and in 2020 ‘Black Panther’ star Chadwick Boseman died at 43. years of colon cancer.

“It was something we had never heard of or seen, but it’s now a high percentage of colorectal cancers under the age of 55,” Dahut said.

While pinpointing a cause for the rise in colorectal cancers in young adults is difficult, he said, some factors could be linked to changes in the environment or in people’s diets.

“We’re not trying to blame anyone for his cancer diagnosis,” Dahut said. “But when you see something happening in a short period of time, it’s more likely something outside of the patient that’s causing it, and it’s hard not to at least think – when you have something like colorectal cancer – that something diet-related isn’t impossible.”

The new report also indicates that more people are surviving colorectal cancer, with the relative survival rate at least five years after diagnosis increasing from 50% in the mid-1970s to 65% from 2012 to 2018, in part due to advances in treatment. .

That’s good news, said Dr. Paul Oberstein, a medical oncologist at NYU Langone Perlmutter Cancer Center, who was not involved in the new report. General trends suggest that colorectal cancer incidence and mortality rates are slowly decreasing.

“If you look at the overall trends, the incidence of colon cancer in this report went from 66 per 100,000 in 1985 to 35 per 100,000 in 2019, almost half that,” Oberstein said.

“The changes in the death rate are even more impressive,” he said. “In 1970, that was a long time ago, the colorectal cancer death rate was 29.2 per 100,000 people, and in 2020 it was 12.6 per 100,000. So a dramatic drop of more than 55% of deaths per 100,000 people.”

Colorectal cancer is the second leading cause of cancer death in the United States and the leading cause of cancer-related death in men under age 50.

Dahut said the best way to reduce your risk of colorectal cancer is to follow screening guidelines and have a stool-based test or visual exam such as a colonoscopy when recommended. Any suspicious polyps can be removed during a visual examination, reducing your risk of cancer.

“At ACS, we recommend if you’re at average risk, you start screening at age 45,” Dahut said. “Usually your subsequent screening is based on the results of this screening test.”

An “alarming” change towards the youngest

For the new report, researchers from the American Cancer Society analyzed data from the National Cancer Institute and the Centers for Disease Control and Prevention on cancer screenings, cases and deaths.

Researchers found that between 2011 and 2019, colorectal cancer rates rose 1.9% each year among people under 55. And while overall colorectal cancer death rates fell 57% between 1970 and 2020, among people under 50, death rates have continued to rise 1% per year since 2004.

“We know that rates are increasing in younger people, but it’s alarming how quickly the overall patient population is getting younger, despite declining numbers in the overall population,” Rebecca Siegel, Chief Scientific Officer for Research on surveillance at the American Cancer Society and chief author of the report, said in a press release. “The trend toward more advanced disease in people of all ages is also surprising and should motivate everyone 45 and older to get screened.”

Certain regions of the United States seemed to have higher rates of colorectal cancer and death than others. Those rates were lowest in the West and highest in Appalachia and parts of the South and Midwest, the data showed. The incidence of colorectal cancer ranged from 27 cases per 100,000 people in Utah to 46.5 per 100,000 in Mississippi. Colorectal cancer death rates ranged from about 10 per 100,000 people in Connecticut to 17.6 per 100,000 in Mississippi.

There were also significant racial disparities. The researchers found that colorectal cancer cases and deaths were highest in American Indian/Native and Black communities in Alaska. In men specifically, the data showed that colorectal cancer death rates were 46% higher among American Indian/Alaska Native men and 44% higher among black men than white men.

The report also indicates that more left-sided tumors have been diagnosed, meaning that an increasing percentage of tumors are occurring closer to the rectum. The proportion of colorectal cancers there has steadily increased, from 27% in 1995 to 31% in 2019.

“Historically, we’ve been more worried about tumors on what we call the right side,” Oberstein of NYU Langone said.

“But the increase in incidence, especially in young people, seems to be happening not only in the most serious tumors, but also in those that we think are less serious,” he said, referring to tumors on the left side. “It raises questions about whether anything is changing about the risks and future people who are going to get colon cancer.”

Looking ahead, researchers estimate there will be 153,020 cases of colorectal cancer diagnosed in the United States this year and about 52,550 colorectal cancer deaths, including 3,750 – or 7% – in people under 50. years.

“These very concerning data illustrate the urgent need to invest in targeted cancer research studies dedicated to understanding and preventing early colorectal cancer,” said Dr. Karen Knudsen, CEO of the American Cancer Society, in the press release. “The shift to diagnosis of more advanced disease also underscores the importance of screening and early detection, which saves lives.”

Screening recommended for ages 45 and over

The report’s findings, including the rise in colorectal cancer in young adults, are “disturbing,” said Dr. Joel Gabre, an expert in gastrointestinal cancers at Columbia University Irving Medical Center, in an email.

“This mirrors other recently published findings demonstrating an increasing incidence of colorectal cancer in young people. What worries me most, however, is the lack of a clear cause and patients being diagnosed late. I think it’s an area where more research funding is needed to understand this truly concerning rise,” wrote Gabre, who was not involved in the report.

Gabre says he knows what it’s like to look into the eyes of his young patients and tell them they have colorectal cancer, and “it’s devastating.”

“They have young families and a big chunk of their lives ahead of them. That’s why I encourage my patients aged 45 and older to get tested,” Gabre said. “I also encourage people to tell their doctor if they have a family history of colon cancer. There are genetic tests we can do to identify some at-risk patients early before they develop cancer.”

The findings underscore the importance of colorectal cancer screening, said Dr. Robin Mendelsohn, gastroenterologist and co-director of the Center for Young Onset Colorectal and Gastrointestinal Cancers at Memorial Sloan Kettering Cancer Center, in an email.

“The age to start screening was recently lowered to 45, which will help screen more people, but we still need to better understand why we are seeing this increase, which we are actively looking at,” Mendelsohn wrote, was not involved in the new report.

Mendelsohn says she has seen an increase in advanced colorectal cancers and diagnoses in her younger patients, and she says to watch for symptoms such as rectal bleeding, abdominal pain and changes in bowel habits.

“Until we understand better, it’s important for patients and providers to recognize these symptoms so they can be assessed quickly,” she said. “And, if you are old enough to get tested, please do so.”

Related stories

Latest US Articles

More stories that might interest you

Leave a Comment