Recent report confirmed curious increase of colorectal cancer among young adults

On Tuesday, February 28, 2017, a report from the Journal of National Cancer Institute confirmed that colorectal cancer, colon and rectum cancer (CRC) is curiously increasing among young adults (younger than 50 years) -- and the most rapid gains are for individuals in their 20s and 30s.

Specifically, rectal cancer incidence rates increased by 3.2% per year from 1974 to 2013 in adults 20 to 29 years old. In contrast, rates generally declined in adults 55 years and older.

“People born in 1990, like my son, have double the risk of colon cancer and quadruple the risk of rectal cancer” compared to the risk someone born in 1950 faced at a comparable age, said Rebecca Siegel, an epidemiologist with the American Cancer Society.

I was 41 when I had a feeling in my stomach that something was not functioning as it should. After six months of tests and analysis, visits to different hospital departments, and consulting with the best specialists; none of them considered cancer given my healthy lifestyle and young age. The final report identified depression to explain the sharp regular pains in my stomach. One week after this diagnosis I had blood in my stool. I took a picture and I went back to my healthcare provider who insisted that depression could cause hemorrhoids and the blood may come from there… “Mr. J. you will be fine the day you decide to be.” This is what the doctor told me as I was leaving his office.

So, I decided to be fine, and went to another doctor. Without explaining anything or discussing my recent findings I asked him to prescribe me a colonoscopy. This is when my cancer was discovered. Luckily, I am one of the rare cases where the tumor didn’t have enough time to do more damage -- this is not the case with most people.

Taking into account my personal experience, along with the many similar cancer survivor stories; I think a number of actions should be taken to decrease the rising number of CRC in young adults:

1. Educate clinics about the rising probability of disease in people younger than age 55. Even if the body mass index (BMI) is normal and a healthy lifestyle and regular physical activity are part of daily life; someone can have CRC -- even individuals in their 20s and 30s.

A 40-year-old mother of four from Bowie, Md., had chronic constipation for years before seeking help at a freestanding emergency room clinic in 2015 because she was in so much pain. There, a scan detected a tumor in her colon “the size of a tennis ball,” she said.

A gastroenterologist who examined her a year earlier merely told her to increase her intake of dietary fiber to ease her constipation, she said. Fortunately, her disease had not spread.

2. Earlier screening: Guidelines state that screening should commence at age 50 for individuals at average risk of disease, but earlier for those at increased risk; including those with a family history of CRC or adenomatous polyps.

Screening before the age of 45 is not supported and, in the USA alone; would add approximately 20 million people to the screening-eligible population. However, it is worth noting that in 2013 there were about 10,400 new CRCs diagnosed in adults 40 to 49 years of age and 12,800 cases in adults 50 to 54 -- similar to the total number of cervical cancers (12,300) for which screening of 95 million women age 21 to 65 years is recommended.

For Chris, who was 29 when he found out he had colon cancer, the first symptoms were weight loss and loss of appetite. “I lost about 20 pounds and I wasn’t really trying to lose weight, but I just didn’t enjoy eating,” said Chris, now 30. He had just moved to New York City and did not have a regular doctor but was fortunate enough to find a doctor who was determined to make a diagnosis quickly and ordered several blood tests and an ultrasound scan that found tumors that had already spread to Chris’ liver.

3. Educational Campaigns: These results highlight the need for etiologic research to explain causes for the underlying increase in disease risk in young birth cohorts.

Beyond awaiting scientific discovery and the widespread adoption of healthier living, meaningful action can be taken to mitigate premature morbidity and mortality from this disease through educational campaigns about the importance of timely follow-up of CRC symptoms, regardless of patient age, and age-appropriate screening.

The symptoms are typically vague, including general digestive complaints like diarrhea or constipation, cramping and abdominal pain. Be connected to your body and mindful to the body signs will help to do a first assessment to decide what to do next. If you have one of the above symptoms for weeks and is not getting better; you should start investigating.

The campaigns can educate changes to reduce the risk of CRC. Experts attribute lowering cancer rates to changes in risk factors, particularly lifestyle changes like smoking cessation, regular physical activity and healthier diets. Diets that include more fruits, vegetables and fiber and less red and processed meat are linked to lower colorectal cancer risk.

“The honest truth is nobody knows 100 percent why there is an increase,” said Dr. Mohamed E. Salem, an assistant professor at Lombardi Comprehensive Cancer Center at Georgetown University. He said that he is older than about 60 percent of his patients — and he is 42. “It’s hard to blame it on obesity alone.

Key takeaway:

Don’t be paranoid each time you have a pain in your tummy, especially if you had ate a spicy dinner the day before. Connect with your body and listen to the signals it sends you. Maintain a healthy diet, engage in regular physical activity, enjoy a happy lifestyle; and you will be fine. If the symptom(s) worsen; contact a healthcare provider and research your other resources as well.

I hope the website we are building Cancer Survivors Support Center will be ready soon and can help bring some answers to this mysterious disease that is cancer. For now, please visit our Facebook page.