Additional Coverage:
- Rectal cancer rates are rising in U.S., driving an increase in illness in younger adults (nbcnews.com)
Rectal Cancer Rates on the Rise, Especially in Younger Adults
A new report from the American Cancer Society reveals a concerning trend: colorectal cancer diagnoses are increasing significantly in individuals under 65, largely driven by a surge in rectal cancer cases across all age groups.
For generations, colorectal cancer was primarily considered a disease of older age. However, the latest findings indicate a dramatic shift, with nearly half (45%) of new diagnoses now occurring in people younger than 65 – a substantial leap from 27% in 1995. This increase stands in stark contrast to the declining rates observed in those 65 and older.
Rectal cancers, specifically, are a growing concern. They now account for nearly one-third of all colorectal cancer diagnoses, up from 27% in the mid-2000s. Between 2018 and 2022, diagnoses of rectal cancer rose by 1% annually across all age demographics.
“We didn’t have an epidemic of young people with colon or rectal cancer up until recently,” noted Dr. Arif Kamal, chief patient officer for the American Cancer Society.
“It’s really a phenomenon in the last five years or so that we’ve started to see this.” Researchers are still working to understand the underlying reasons for this particular increase.
The report highlights a clear trend in colorectal cancer rates since the late 1990s:
- Ages 20 to 49: Increased by 3% each year.
- Ages 50 to 64: Increased by 0.4% each year.
- Ages 65 and older: Decreased by 2.5% each year.
This shift toward younger patients is prompting medical professionals to emphasize earlier education about the disease. Andreana Holowatyj, an assistant professor of hematology and oncology at Vanderbilt University Medical Center, expressed concern about the delay between symptom presentation and diagnosis in younger patients.
“There’s about a 4- to 6-month gap between symptom presentation and diagnosis, which is alarming,” she stated. “How do we educate Gen Zers, millennials and future generations?”
Understanding Rectal Cancer Symptoms
Colorectal cancers encompass cancers of the large intestine, with the rectum located at its very end, just before the anus. Dr. Kamal explained that tumors in the rectum often present with more noticeable symptoms compared to those in the colon.
While colon cancer symptoms can be vague – including fatigue, abdominal pain, bloating, and unexplained weight loss – rectal cancers are frequently accompanied by bright red blood on toilet paper or in the toilet bowl, and a strong urge to use the bathroom even after a bowel movement.
“While we don’t know the drivers” of the increase in rectal cancer, Kamal said, “it does emphasize the importance of knowing your body and reporting symptoms to your doctor early.”
When to Consider Screening
Historically, colorectal cancer screening was recommended for individuals 50 and older. However, in 2021, the U.S. Preventive Services Task Force lowered the recommended screening age to 45 due to evolving understanding of the disease.
Individuals with higher risk factors, such as a family history of colorectal cancer, a history of precancerous polyps, or inflammatory bowel disease, may be advised to begin screening even earlier.
Despite the updated guidelines, the new report indicates that just over a third of people aged 45 to 49 are getting screened. Alarmingly, approximately three-quarters of colorectal cancers in those under 50 are diagnosed at an advanced stage.
Given the current trends, Dr. Kamal suggests that the recommended screening age may need further reevaluation in the coming years.
Caitlin Murphy, a cancer epidemiologist at the University of Chicago, highlights a growing interest in “fast-tracking” individuals under 45 who exhibit symptoms suggestive of colorectal cancer. “Patients tend to get stuck in referral loops, where they get referred to this person who then refers them to this person, and just goes on and on and on for months,” Murphy explained. “We want to make sure that people get timely treatment, so the cancer doesn’t continue to advance while they’re waiting for it to be diagnosed.”
Reducing Your Risk
Colorectal cancer is currently the leading cause of cancer death in Americans under 50. The American Cancer Society estimates that 158,850 new colorectal cancers will be diagnosed in 2026, with approximately 55,230 deaths, nearly a third of which will occur in individuals under 65.
Researchers have identified several controllable risk factors linked to more than half of colorectal cancers, including smoking, high alcohol consumption, lack of exercise, and excess body weight. Adopting dietary changes, such as increasing fiber, vegetable, fruit, and whole grain intake, and reducing processed meat consumption, can also significantly lower your risk.