Perspective: For young adults, colorectal cancer is a growing threat. It’s unclear why.
By Franklin G. Berger April 13 at 8:45 AM Colorectal cancer remains a major source of cancer incidence and death in the United States. The American Cancer Society estimates that in 2019, there will be 145,600 new cases of the disease and 51,020 deaths across the United States, making it the fourth most diagnosed form of cancer and the second leading cause of cancer mortality.
Unfortunately, such is not the case for young people. Colorectal cancer incidences and deaths have been increasing in the past 30 years in people under 50. As a scientist conducting basic research on colorectal cancer, I have been generally aware that this was occurring. But two recent events impassioned me about the issue.
Second, at about the same time, I attended a conference where I met a number of young people, including several in their 20s and 30s, who had been diagnosed with colorectal cancer and were in the middle of fighting it. I also met parents who lost young adult children to the disease. The emotions displayed by these people were particularly acute, representing the intersection of anger, resentment, embarrassment, hopelessness and fear.
But screening is not typically recommended for those under 50. This — along with a general lack of awareness about colorectal cancer and its symptoms among young people, their families and their primary care providers — results in prolonged times for symptomatic patients to obtain a firm diagnosis. Late diagnoses often result in more advanced stages of the disease, when it is harder to treat.
Indeed, a recent study shows that obesity is associated with increased risk of early-onset colorectal cancer in women. It is possible, therefore, that microbes may be key in linking early life exposures to later life health. Our research group is examining the possibility that increasing colorectal cancer incidences in young adults may be a consequence of environmental exposures that occur at very young ages, during the first few years after birth.
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