Colon Cancer in Young Adults
Colon cancer isn’t typically considered a young person’s disease. But in February 2017, a study came out in the Journal of the National Cancer Institute reporting that rates of colon cancer among those ages 20 to 39 had been rising about 1 to 2 percent per year. And while that is a statistically small increase (and the vast majority of cases still involve those over 50), the upward trend in colon cancer diagnoses shouldn’t be ignored.
Why is colon cancer becoming more common in young adults?
It’s important to look at the big picture and not just be alarmed by the numbers. “It may not necessarily be that younger adults are actually getting colon cancer more,” says Gregory FitzHarris, MD, a colorectal surgeon at Sentara CarePlex Hospital in Hampton, VA. “It may be that, thanks to increased awareness and screening, more cases are being discovered earlier.”
Primary care providers are more in tune with symptoms that may suggest colon cancer, and less likely to ignore them even in younger patients. That can lead to recommending a colonoscopy that otherwise might not be done for another decade or more. Also, as knowledge of how genetics plays a role in the development of the disease increases, more young people are being screened based on their family history.
Don’t ignore colon cancer warning signs
“The number one symptom is unexplained rectal bleeding,” says FitzHarris. If you are seeing blood in your stool, it’s important to get it checked out by your doctor. “In the vast majority of cases, this sort of bleeding is totally benign – usually caused by hemorrhoids.”
But if you treat the hemorrhoids and the bleeding continues, your doctor should recommend a colonoscopy. “Symptoms like this are often brushed off by young people – and their doctors – but if you ignore it you could miss the very small percentage that are cancer,” he says.
Another red flag is anemia. While this is often attributed to having heavy periods, in some cases it can indicate the blood loss is coming from the gastrointestinal (GI) tract. This can happen even when there’s no visible blood in your stool. “The blood loss can be so slow that you don’t see it, but the GI tract should be considered as a possible source of the blood loss,” says FitzHarris.
Is it time for a colonoscopy?
For people at average risk of colon cancer, the American Cancer Society recommends getting a colonoscopy starting at age 50 (age 45 if you are African American). But if you have unexplained rectal bleeding or anemia, your doctor may recommend one sooner.
Early screening due to family history
There is also a strong genetic link to colon cancer. So if you have a first-degree relative (mom, dad, sibling) who was diagnosed with it younger than age 60, you should be screened earlier than 50. As a general rule of thumb, your doctor will probably recommend your first colonoscopy at 10 years younger than your relative was when he or she got cancer. (In other words, if your mom was diagnosed at age 48, you’d have your first colonoscopy at age 38.)
One particular genetic mutation, called Lynch syndrome or HNPCC, puts people at even higher risk. If you have a family history of both uterine and colon cancer, your doctor may recommend testing for this gene. If you test positive, colonoscopies are recommended starting in your 20s.
And while it might be tempting to skip the colonoscopy in favor of newer, less invasive tests (such as Cologuardâ), FitzHarris warns that a colonoscopy is still the best screening tool. “Many other tests only detect cancer, but a colonoscopy can detect and remove precancerous polyps,” he says.
Take steps to reduce your risk
The lifestyle factors that help protect you from a variety of health conditions also help prevent colon cancer. To decrease your risk, be sure to:
- Eat a low-fat, high-fiber diet
- Maintain a healthy weight
- Exercise regularly
- Don’t smoke