Article: By Korin Miller for Self

The following article is, “By Korin Miller for Self.” We have permission to include this by Amy Rushlow, Deputy Editor | SELF.

You’d be hard-pressed to find many millennials concerned about colorectal cancer. (Since cancer that affects the colon, aka large intestine, and rectum, which connects the colon to the anus, are so similar, they’re often grouped together.) After all, these diseases largely impact older people. But a surprising new study from the American Cancer Society found that, while the vast majority of colorectal cancer cases are in older people, they’re sharply increasing among twenty- and thirtysomethings, too.

Nearly 90 percent of all colorectal cancer cases are diagnosed in people over age 50, according to the study, which was published in the Journal of the National Cancer Institute. But colon cancer incidence rates (the number of new cases per population in a given time period) in 20- to 39-year-olds have increased between 1 percent and 2.4 percent annually since the mid-’80s, and rectal cancer incidence rates have increased 3.2 percent each year from 1974 to 2013 in 20- to 29-year-olds.

Bizarrely, colorectal cancer cases have been steadily decreasing for people born between 1890 and 1950 at the same time. Colorectal cancers are the third most common cancer diagnosed in men and women in the United States, according to the American Cancer Society, which estimates that more than 95,500 cases of colon cancer and nearly 40,000 cases of rectal cancer will be diagnosed this year.

See the major symptoms below:

The study’s researchers are particularly concerned about rectal cancer due to its especially fast-rising incidence rate among younger people. “As nearly one third of rectal cancer patients are younger than age 55 years, screening initiation before age 50 years should be considered,” researchers concluded in the study.

Experts “really don’t know why” colorectal cancer occurs in younger people, Debra A. Vachon, M.D., FACS, surgical director at The Center for Inflammatory Bowel and Colorectal Diseases at Mercy Medical Hospital, tells SELF. One of the current theories is that it may be obesity-related, since obesity is a risk factor.

There are other environmental and lifestyle factors associated with an increased risk for colorectal cancers, Mark Friedman, M.D., a gastroenterologist at Moffitt Cancer Center, tells SELF. “These are things like lack of exercise, unhealthy eating, and diabetes—all of which are prevalent in millennials,” he says.

With that said, some of the young people getting diagnosed with colorectal cancer don’t have these risk factors, Dr. Vachon says. In those cases, there’s “no obvious reason” why this significant increase is happening, Wafik S. El-Deiry, M.D., Ph.D., F.A.C.P., professor of medical oncology and deputy cancer center director for translational research at the Fox Chase Cancer Center, tells SELF.

When cancer occurs in young people, there is typically a genetic link (meaning someone else in a patient’s family also had the disease), but that wouldn’t cause numbers to collectively rise like this, Dr. El-Deiry says.

Nancy You, M.D., associate professor of surgical oncology at MD Anderson Cancer Center, tells SELF that she and her colleagues have also noticed this disturbing trend. “Because this age group [does] not typically undergo screening like [the colonoscopies] performed in adults over age 50, the rising incidence is not due to increased screening/detection,” she says.

Symptoms of colorectal cancer in young people are similar to what they are in those who are older—they’re just more likely to be missed because young people wouldn’t automatically think they have cancer when they start having symptoms, Dr. Vachon says. Those symptoms include frequent bleeding when you poop, a change in bowel habits, constant bloating, constant gas, and having thin, ribbonlike stools.

Low energy and weight loss can also be symptoms, Dr. You says, adding that sometimes the signs of colorectal cancer can be “very, very subtle.” That’s why a greater number of patients who are diagnosed under age 50 already have stage 3 or 4 cancer, compared to their older counterparts, she says.
“The biggest issue with young people and [colorectal] cancer is that they’re oftentimes diagnosed much later because it’s not on anybody’s radar,” Meagan Costedio, M.D., a colorectal surgeon at Cleveland Clinic, tells SELF. While young people can get more aggressive surgeries than older patients because they’re healthier, their overall prognosis is typically the same, she says.

Dr. Friedman agrees. “The prognosis of colorectal cancer is usually related to the stage,” he says. “The later the stage, the poorer the prognosis.” And the longer it could take to get treatment.

“Standard treatment is to remove the segment of colon that contains the polyp [aka the growth] with the surrounding lymph nodes,” Anton Bilchik, M.D., Ph.D., professor of surgery and chief of gastrointestinal research at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. If a polyp contains cancerous cells, a doctor can remove it during a colonoscopy. However, if the cancerous cells have spread to the surrounding lymph nodes, the standard procedure is to remove that portion, plus the nodes. Chemotherapy may also be used if the cancer has spread, he says.