Under 50? Don’t Take Colon Cancer Off Your Radarby Lisa Davis Health Writer
Let’s share some good colorectal cancer news first (yep, there is some!): Rates have been dropping since the 1980s, mostly due to colonoscopies and other screening tests for people 50+. Now the bad news (sorry, but you knew that was coming): Rates have been climbing among Millennials (roughly 24 to 39 years old in 2020) and Gen X-ers (about 40 to 54). And not just by a little. Compared to 29-year-olds in 1979, 29-year-olds today have twice the risk of colon cancer and quadruple the risk of rectal cancer.
The Role of Obesity
Experts aren’t sure exactly what’s behind the rise in colorectal cancer in younger people, but likely culprits are increasing obesity, unhealthy diets, and physical inactivity. “People who are overweight are more likely to have conditions that cause chronic low-level inflammation,” says Rebecca Siegel, MPH, strategic director of surveillance information services for the American Cancer Society. “Chronic inflammation can cause DNA damage over time that leads to uncontrolled cell growth and cancer.” And it’s not just colon cancer. Five other cancers related to obesity, including gallbladder, kidney, and pancreatic, are also on the rise in younger folks.
The Diabetes Connection
Excess weight delivers a double whammy. Not only does it cause inflammation that encourages cells to turn cancerous, it also leads to other diseases that make cancer more likely to develop. For instance, studies suggest that type 2 diabetes raises the risk of colorectal cancer. If so, that doesn’t bode well for the future: Type 2 diabetes used to be called adult-onset diabetes because it was so rare in children and teens, but it’s been rapidly increasing in younger Americans since the 1980s.
How Diet Helps–and Hurts
What you eat also affects your likelihood of developing colorectal cancer. Fruits, vegetables, and whole grains are protective, while a meat-heavy diet raises risk. Processed meats like hot dogs, ham, and bacon are especially problematic. An analysis of more than 800 studies concluded that eating about four strips of bacon a day, or an equivalent amount of other processed meat, raises colorectal cancer risk by 18 percent. Unfortunately, researchers say, the typical diet among young people has been getting worse over the past few decades: less produce and whole grains; more sodium and sugary drinks.
A Sneaky Danger
There may be other, surprising factors at play in the rising colon cancer rates among the young. One possibility: overuse of antibiotics, which can knock out good-for-you bacteria in the digestive system along with the bad guys. “Information about how the gut microbiome influences health in general, and cancer in particular, is still in its infancy,” Siegel says, “but it would make sense that something that changes the microbiome, like antibiotics, might be important.” So don’t give your doctor the stink-eye for refusing to prescribe antibiotics. Remember: They don’t work against colds or other viruses, anyway!
Please Quit Smoking, Already
More than 16 percent of Millennials smoke, according to the Centers for Disease Control and Prevention—a higher percentage than in older or younger generations. You know you’ve gotta stop. Smoking doesn’t just raise your risk of lung cancer and heart disease; it’s also linked to at least 11 other cancers— including colorectal.
While You’re At It, Cool It With the Drinking, Too
Alcohol also raises your risk of colorectal cancer, possibly because bacteria that normally live in the colon and rectum turn it into a chemical called acetaldehyde. In lab animals, acetaldehyde can cause cancer—and the same may be true in humans, according to the American Cancer Society. If you drink, keep it moderate. (In a 2017 survey by the federal government, about 43 percent of younger Millennials reported occasional binge-drinking—meaning five or more drinks on a single occasion for men and four or more for women.)
A Little Exercise Goes a Long Way
Another risk reducer? Get moving! Regular exercise cuts colon cancer risk by 20 percent or more. Working out reduces chronic inflammation, lowers levels of insulin and certain chemicals called growth factors, and changes the metabolism of bile acids, among other things, all of which may play a role in colon cancer, the National Cancer Institute reports. You don’t have to go crazy. Simply walking briskly counts, though more intense exercise seems even better. Aim for half an hour of exercise most days of the week, more if you can.
Screen, Screen, Screen
The American Cancer Society recently lowered its recommended starting age for screening to 45, but if a close family member was diagnosed with colorectal cancer before age 60, or if two family members were diagnosed at any age, start screening at 40, or when you’re 10 years younger than the earliest diagnosis—whichever comes first. During colonoscopy, a doctor looks for and removes polyps, the small growths that can develop into cancer. There are also other effective tests, like fecal blood screening. Talk to your doc about your options. The best test? The one you’ll actually do.
Take Symptoms Seriously
If you have a change in bowel habits that lasts more than a month—constipation, diarrhea, a different consistency—tell your doctor. Ditto if you have rectal bleeding, blood in your stool, or persistent cramps, gas, or abdominal pain. Younger adults who develop colorectal cancer are 58 percent more likely than older people to have late-stage disease by the time they’re diagnosed, probably because the problem isn’t on their radar—or their doctor’s. “Young people with these symptoms usually don’t have cancer, but sometimes they do,” Siegel says. “And survival is much more likely with earlier diagnosis.”
Trust Your Instincts
In a survey of people diagnosed with colorectal cancer before age 50, 67 percent saw at least two doctors before their cancer was found, and some saw as many as four, says Ronit Yardin, Ph.D., director of medical affairs at the Colorectal Cancer Alliance. Because cancer isn’t top-of-mind when a younger patient comes in, a doctor might not recommend tests that could identify colorectal cancer at first, focusing instead on other possible explanations, like hemorrhoids or inflammatory bowel disease. But if your symptoms are persistent, you need to be persistent too, Yardin says.