More Younger People Are Getting Colorectal Cancers, and Doctors Don't Know Why
The American Cancer Society said Wednesday that about 20% of new colorectal cancer diagnoses were in patients under 55 in 2019, compared with 11% in 1995. Some 60% of new colorectal cancers in 2019 were diagnosed at advanced stages, the research and advocacy group said, compared with 52% in the mid-2000s and 57% in 1995, before screening was widespread. Cases and death rates for colorectal cancer have continued a decadeslong decline overall thanks to screening, better treatments and reductions in risk factors such as smoking, the ACS report’s authors said. But the shift of the burden toward younger people and diagnoses at more advanced stages has oncologists on alert.
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Colorectal cancer is one of the most common cancer types in the U.S. and the second-deadliest behind lung cancer. Some 153,000 diagnoses are expected in 2023, ACS estimated, including some 19,500 cases in people under 50. The cancer is most common among people 65 to 74, but the case rate among people under 50 has risen quickly. Actor Chadwick Boseman’s death in 2020 from colon cancer at age 43 drew more attention to the trend.
Researchers aren’t sure why rates among younger people are increasing. Changes in known risk factors including unhealthy diets, alcohol consumption and physical inactivity could contribute but don’t fully explain the trend, oncologists said. Some think environmental changes could be reshaping the makeup of microorganisms in people’s bodies, called the microbiome, putting them at risk.
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Drivers of the shift toward later-stage diagnoses also aren’t clear, doctors said, but plateauing screening rates likely contribute. Younger patients also tend to be diagnosed at later stages, in part because doctors can mistake symptoms such as abdominal pain, blood in the stool and unintended weight loss for something else in those age cohorts.
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