The headlines sound alarming: “If you’re under 30, your risk for colon cancer just doubled.” “Study finds colorectal cancer rates have risen dramatically in Gen X and millennials.” “Colorectal cancer rates soar in younger people.”
The stories were about a February 2017 study published in the Journal of the National Cancer Institute that showed rates of colorectal cancer – cancer that starts in the colon or rectum – have increased for every generation born since 1950. This is a trend my colleagues and I have witnessed firsthand in the Metroplex.
It’s estimated that more than 135,000 people in the United States will be diagnosed with colorectal cancer in 2017. In Texas, about 37 people per 100,000 get colorectal cancer every year. The vast majority of these cases – more than 90 percent – will be diagnosed in people older than 50.
The good news is that overall colorectal cancer rates have dropped by 3 percent per year since 2003. Among Americans older than 50, colorectal cancer rates have fallen 32 percent since 2000, and deaths from the disease by 34 percent. This is largely due to guidelines that recommend people age 50 and older who are at average risk for colorectal cancer begin regular screening, such as getting a colonoscopy. We use colonoscopies not only to diagnose cancer but also to prevent it by removing precancerous polyps.
But why is the rate rising for younger people? What can Gen Xers and millenials do to mitigate their risk, and what symptoms should they watch out for?
What this study means for Gen Xers and millennials
While colorectal cancer rates increasing among younger adults is concerning, it’s important to look at the numbers in context.
An author of the study said a person born in 1990 has double the risk of colon cancer and four times the risk of rectal cancer as someone born in 1950. That sounds scary, and we shouldn’t ignore that fact. But we also can’t forget the actual numbers, which are very small. Over the past three decades, the number of people in their 20s diagnosed with colorectal cancer increased from one to two cases for every 200,000 people. For adults younger than 50, the rate is seven in 100,000 people.
We’re not 100 percent sure why younger people seem to be at increased risk for colorectal cancer. But changes in diet and lifestyles among younger generations likely have contributed to the increases we’re seeing.
How can you reduce your risk for colorectal cancer?
Some risk factors for colorectal cancer can’t be avoided, such as family history. But there are lifestyle changes you can make to lower your risk of developing colorectal cancer.
1. Manage your weight
One factor that’s associated with increased risk for colorectal cancer is obesity. A March 2017 research review found strong evidence linking obesity to 11 cancers, including colon and rectal cancers. According to the National Cancer Institute, people who are obese are about 30 percent more likely to develop colorectal cancer as compared to people at a normal body weight. Here in Texas, we have the 10th-highest obesity rate in the country – 32.4 percent among adults – which could put our population at higher risk for colorectal cancer. Maintaining a healthy weight can lower this risk.
2. Stay physically active
It’s not just body weight that can increase the risk for colorectal cancer. Activity levels also can play a role. A January 2017 study found that people who took part in nonvigorous physical activity, such as walking or yoga, for four or more hours per week reduced their risk of colon cancer by 20 percent. Those who exercised at least five hours per week lowered their risk by 25 percent.
3. Eat healthy
You also can lower your risk for colorectal cancer through your dietary choices. Diets that are high in vegetables, fruits, and whole-grain fibers are associated with a lower risk of colorectal cancer. And diets that are high in red or processed meat can raise your risk of colorectal cancer. In fact, in 2015, the International Agency for Research on Cancer classified processed meat as carcinogenic, or a cause of cancer.
Examples of red or processed meat include:
- Hot dogs
- Lunchmeat, such as bologna
4. Quit smoking
Though smoking is widely known as a cause of lung cancer, people who have smoked for long periods are more likely than nonsmokers to get colorectal cancer. Smokers also are more likely to die from colorectal cancer than nonsmokers. If you don’t smoke, don’t start. If you do smoke, quit. Find tips to stop smoking.
5. Drink in moderation
Heavy use of alcohol also has been linked to higher rates of colorectal cancer. Heavy alcohol use is defined as more than two alcoholic drinks per day for men and one drink per day for women. Limiting your alcohol consumption may help lower your risk for colorectal cancer.
6. Manage medical conditions
Other medical conditions also can increase your risk of colorectal cancer. Conditions such as Crohn’s disease and ulcerative colitis, the primary chronic diseases associated with inflammatory bowel disease (IBD), have been associated with an increased risk of colorectal cancer. And several studies have pointed out an increased risk for developing colorectal cancer in patients with Type 2 diabetes. If you’ve been diagnosed with IBD or Type 2 diabetes, make sure to follow your doctor’s instructions for treatment, and tell your doctor if you experience any new or worsening symptoms.
When should you be screened for colorectal cancer?
The current guidelines from the U.S. Preventive Services Task Force recommend colorectal cancer screening begin at age 50 for people at average risk. Screening methods can include colonoscopy, fecal immunochemical test (FIT), and computed tomographic (CT) colonography.
Your doctor may recommend you begin screening before age 50 if you’re at increased risk for colorectal cancer. Risk factors can include a:
- Family history of colorectal cancer or polyps
- Personal history of colorectal cancer or polyps
- Personal history of chronic IBD
Family history of colorectal cancer or polyps is a major influencer of when patients should begin screenings. The general rule is to begin screening 10 years before the age at which a family member developed their cancer. So, for example, if you have a family member who was diagnosed with colorectal cancer at 51, you should start being screened at age 41.
It’s not unusual to see a patient who’s had colorectal cancer symptoms for a year or more and never thought to get checked out. They blame their symptoms on hemorrhoids or other benign conditions. Reporters for recent stories talked to patients whose doctors also ignored symptoms, not suspecting colorectal cancer in such a young patient.
Know your body and don’t ignore changes. Be aware of your risk factors for colorectal cancer, especially family history, and talk to your doctor about how to lower your risk and when to begin screening.
See your doctor right away if you experience any of these potential colorectal cancer symptoms:
- Anemia, or iron deficiency
- Blood in the stool
- Cramps or abdominal pain
- Diarrhea or constipation that lasts more than a few days
- Loss of interest in food
- Unintended weight loss
Any diagnosis of an iron deficiency could be cause for concern, especially for men. Any man with an iron deficiency should be screened for colorectal cancer. In women, blood loss during the menstrual cycle is the usual cause for iron deficiency, but any iron deficiency without a recognized cause is reason to be screened.
I’m concerned about the recent upward trend in younger people developing colorectal cancer. But I don’t think it’s a cause for panic. With healthy lifestyle choices and good screening habits that factor in family history, we can reverse these increasing trends and get younger adults back on a healthier track.