Colon cancer and millennials

Colon cancer is the third most prevalent cancer in the United States, resulting in approximately 50,000 deaths per year.

The good news: The overall incidence of colon cancer has been steadily decreasing.

The bad news: The incidence of colon cancer in millennials has been gradually increasing.

What could be some reasons for this increased occurrence in millennials?

Although it is not definitively known whether younger individuals with colon cancer have more aggressive cancerous cells or if the characteristics just vary from the expected norm, there are a few potential reasons for this variance in incidence when compared to older individuals.

• Millennials are not as quick to have a primary care provider
• A common thought amongst younger individuals is that they do not have a need for a primary care provider, or PCP, if they are seemingly healthy without known chronic medical problems. Many millennials are quicker to utilize urgent cares as “primary care” per se – but not always seeing the same provider each time and generally presenting only for severe care concerns.
• It is important to have a PCP that one feels comfortable with in order for them to know and understand the person well, and so they are very well attuned to a person’s baseline health status. In the future, if there is a change in health status or a serious problem, it helps lead to a more efficient pathway to accurate diagnosis by having that baseline knowledge.
• Millennials are more inclined to ignore or disregard some potentially worrisome symptoms of colon cancer, which can include:
• Rectal bleeding – This could range from large amounts of bright red blood in the stool or it could be a small amount of blood noticed on the toilet paper.
• Changes in bowel habits – These changes could be either the classic “pencil-thin stools” that tends to be associated with colon cancer, or new onset of looser, firmer, or more mucous stools.
• Abdominal pain – Albeit a late sign, this can be indicative of a multiple array of gastrointestinal/genitourinary disorders. Colon cancer is not typically high on the radar for a young person complaining of abdominal discomfort, for both patient and provider.
• Weight loss – Generally another late sign, this can signal many types of cancers and/or gastrointestinal disorders.
• Family history awareness
• Interestingly enough, a common phenomenon I have seen is that many young adults are not aware of their family history. Some individuals are able to recall a history of cancer in a first or second degree relative, but when questioned about the type of particular cancer, they are often unsure.
• Therefore, as a millennial, it is very important to be aware of the family history of medical problems. Many types of conditions, not just cancers, can have genetic predispositions.

Individuals who have a family history of colon cancer should be screened with a colonoscopy 10 years prior to the age of the affected family member at the time of their diagnosis. For example, if an individual’s father developed colon cancer at age 40, this individual should start screening colonoscopies beginning at age 30. Those with a family history tend to have more frequent colonoscopies as well, typically on a 5-year basis.

With all of this being said, here are some methods to reduce the risk of colon cancer in otherwise healthy adults:

• Avoid being sedentary
• Engage in regular physical activity as ones able. An acceptable standard goal is 150 minutes per week of moderate activity (approximately 30 minutes, 5 days per week). If one has a fairly sedentary job, make sure to stand and take a short walk at least every hour.
• Consider daily aspirin use (162 mg)
• Use aspirin particularly for those with a higher risk of developing colon cancer (i.e. family history of colon cancer). If there is a history of gastrointestinal bleeding, stomach ulcers or frequent NSAID use, however, aspirin should be used with caution or avoided.
• Incorporate more fiber in the diet
• Studies have shown that high fiber diets (whole grains, cereals, brown rice, oats) help to protect against colon cancer.
• Quit smoking
• Although smoking increases the risk of colon cancer in both genders, it has a higher risk in women. The risk can even be present up to 10 years after smoking cessation (again, particularly in women). Multiple smoking cessation aids are available to assist and can be discussed with primary care providers.

In conclusion, the incidence of colon cancer in millennials is on the rise, while the overall incidence of colon cancer amongst all age groups is decreasing. By establishing a relationship with a primary care provider, being aware of risk factors (i.e. family history) and symptoms of colon cancer, obtaining colonoscopy screenings as indicated, and taking measures to reduce the overall risk of developing colon cancer, patients (as well as providers) can work toward reducing the incidence of colon cancer and promoting health and longevity amongst millennials.