Colorectal cancer is trending younger. Laura Van Metre Baum, M.D., explains what you can do to reduce your risk.
Erica Rimlinger was scolded throughout her childhood to stop telling stories. Nevertheless, she persisted. Erica holds a master’s degree in journalism from the University of Maryland and has spent her 25-year career telling stories for clients that have ranged from nonprofit organizations to corporations, and from magazines to America’s Most Wanted.
Based in Seattle, Erica is an avid hiker and backpacker and is overcoming a fear of heights to learn rock climbing, with mixed results so far. Her favorite part of writing for HealthyWomen.org is sharing stories of women who have overcome tremendous adversity and gone on to advocate for themselves and others. Erica believes telling stories is what helps us make sense of life and all its joys and travails. She believes every woman has a story — and we should never stop telling them. You can find more of her work at www.ericarimlinger.com.diagnoses are now given to people under the age of 55. Known as “early-onset colorectal cancer” or “young-onset colorectal cancer,” these diagnoses refer to colorectal cancer found in people under the age of 50.Do we know why the diagnosis of colorectal cancer in young people is on the rise? Since the 1950s, we have seen rates of young onset colorectal cancer increasing globally. We’ve identified some risk factors, but they don’t fully explain the rise. There are probably multiple factors involved that include lifestyle and dietary habits, as well as environmental or other factors that can impact your health. Since we know that lifestyle and dietary patterns play a role in increasing your risk, it’s important to remember these are the risks we can control. Diets high in processed and ultraprocessed foods and low in fiber,Are there differences in symptoms and survival between early-onset and older-onset colorectal cancer?screening, so they are more likely to be symptomatic by the time they are diagnosed. Symptoms like abdominal pain, weight loss, iron-deficient anemia or changes in bowel habits can be a sign of colorectal cancer. Also, younger people are more likely toin the rectum or the left side of the colon. Thus, they’re also more likely to present with bright red blood mixed in with their stools, which is more common with rectal and left-sided tumors.As for survival rates, this is surprisingly controversial. Early-onset colorectal cancer patients are more likely to have more advanced stage cancer, so they have a worse mortality because of this. Aroundare diagnosed at an advanced stage, compared with 6 out of 10 people who are diagnosed after age 50. Stage-for-stage, though, some recent studies suggestfor younger people are better compared to those who are diagnosed late because they’re getting more intensive therapies. But other studies show no difference or even worse survival rates. We do see that the very young patients, like those under age 30 or 35, generally do worse.While 10% of colorectal cancers diagnosed after age 50 are caused by inherited genetic mutations , we’ve found that genes play a bigger role in early-onset colorectal cancer. Around 15-30% of early-onset colorectal cancers are linked to inherited genetic mutations that cause family cancer syndromes.that also contribute to this risk. We’re also finding more new mutations in tumors of people who have early-onset colorectal cancer. These mutations, known as “somatic mutations,” are mutations in the tumor itself, rather than in the patient’s genetics. Generally, patients with early-onset cancers have different types of mutations than older patients, which may affect their outcomes.I said earlier that people who are diagnosed younger tend to get more aggressive therapy, but that’s not always the case. Some of it also depends on the cancer, where it is located and how aggressive the cancer is. Also, it depends on how well the patient can handle the treatment. Is there a difference in treatment between a person who is 45 and someone who is 68 if both are otherwise healthy? No. But if the patient has other health conditions or can’t handle certain therapies, we adjust treatment to meet the patient’s needs. In general, younger patients are more likely to tolerate and to get a range of treatments.Leading a healthy lifestyle will help, but it’s important to remember we are not really in control of whether we get cancer. We have seen a lot of younger patients who are triathletes, who are doing everything right. I do recommend eating aIt’s important to know colorectal cancer isn’t just a cancer that impacts those over 50. Younger people should talk to their healthcare providers if they have potential symptoms or changes in their bowel habits.Colorectal cancer is different for younger people mainly because they’re in different phases of their lives before age 50. There may be fertility issues to consider with treatment if the patient wants to get pregnant, particularly if they will need radiation. There may be more stressful parenting issues to deal with while getting cancer treatment if they have young children. Relationship issues can be different for younger people. If they need a permanent ostomy bag, for example, they may feel very emotional dealing with that while they’re dating or early in a relationship or marriage. Cancer is disruptive to school and careers and can have a big financial impact. Dealing with colorectal cancer at a young age can be a real setback: Based in Seattle, Erica is an avid hiker and backpacker and is overcoming a fear of heights to learn rock climbing, with mixed results so far. Her favorite part of writing for HealthyWomen.org is sharing stories of women who have overcome tremendous adversity and gone on to advocate for themselves and others. Erica believes telling stories is what helps us make sense of life and all its joys and travails. She believes every woman has a story — and we should never stop telling them. You can find more of her work at www.ericarimlinger.com.
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