What We Know About Young Onset Colorectal Cancer

As a colorectal care clinic, we’ve published, time and time again, everything we can about colorectal cancer. We’ve talked about its symptoms and treatment, we’ve explored the different lifestyle and genetic causes, and we always mention the increased risk for people over 50.

Countrywide, awareness efforts about colorectal cancer have yielded positive results. Every year the mortality rate decreases and early detection continues to grow. Yet, this favorable news only applies to cases where patients are over the age of 50, i.e. “regular-onset colorectal cancer”. In contrast, the rate of young-onset colorectal cancer is on the rise. Currently, 11% of colon cancer diagnoses and 18% of rectal cancer diagnoses occur in people younger than 50.

Alarmingly enough, the National Cancer Institute's cancer research program (Surveillance, Epidemiology, and End Results. otherwise known as SEER), estimates dramatic increases in colorectal cancer rates among people aged 20 to 34. By 2030, SEER estimates a rise of 90% in colon cancer and a 124.2% rise in rectal cancer for people younger than 50. While much is still being researched, here is what we know so far.

The Rates Of Young-Onset Colorectal Cancer Are Increasing Dramatically

The estimated rates above are scary, to say the least, and a big part of it is because young adults simply do not get screened for colorectal cancer, even when they present with symptoms. These statistics have put pressure on the medical world to determine exactly what’s causing the increasing rates. One finding suggested that current screening and treatment guidelines that have regularly been used may not be appropriate for people under 50.

Increase May Be Linked To Diet, Environment, And Genetics

There is still not a definitive answer for why the rate of colorectal cancer in younger adults is increasing, though there are a few indications. Lifestyle risk factors such as obesity, lack of exercise, frequent consumption of red meats and processed foods have been shown to increase the chances of developing colorectal cancer, but not enough to be solely to blame. Instead, it is believed that a combination of diet, environment, and genetics are the cause.

Treatment Outcomes

There is still much conflict over treatment outcomes in the medical world. According to a clinical trial study published by the Journal Of Clinical Oncology, the youngest patients (age 18) and the oldest patients (aged 90) have increased the risk for death and progression compared to middle-aged patients.

Overall, colorectal cancer younger adults are being diagnosed in with more advanced stages and are showing more aggressive biologic features, which is associated with a poorer outcome, but their actual outcome is as good if not better than the outcome of people over 50.

The Role Of Screening

Despite the increase in incidence, colorectal cancer in young adults is still relatively rare. For that reason, many colorectal specialists have come to a general consensus that the screening guidelines should not be adjusted to require colonoscopies at a younger age. If a young patient shows signs of having colorectal cancer, such as blood in stool, it’s recommended that they take a fecal immunochemical test (FIT), which may then be followed by a colonoscopy.

More Information

For many researchers, the goal has become the identification of the cause of the increase in incidence and the biomarkers for colorectal cancer. In the meantime, physicians and colorectal specialists are taking more serious concern over colorectal cancer in young adults exhibiting symptoms.

If you are below the age of 50, be sure to know the risk factors of colorectal cancer and, if you believe that any of them may apply to you, be sure to book an appointment with one our colorectal specialists to discuss whether you are at risk for developing young-onset colorectal cancer.