- The Washington Times - Thursday, March 5, 2020

Colon and rectal cancers are rising among younger adults, according to a study released Thursday.

For individuals younger than 50 years, the incidence of colorectal cancer increased by about 2% each year from 2011 through 2016, researchers said in a new report published by CA: A Cancer Journal for Clinicians.

In contrast, there were rapid reported declines in incidence for those 65 years and older — down by about 3% annually during those same years and continuing a trend from the 2000s. For those aged 50 to 64 years, researchers found, the rate rose by about 1% annually.

Experts said better monitoring was a key factor in the decline among older patients, but the increase among younger adults is a puzzle.

“Incidence rates are declining in adults 65 and older largely because of the rapid uptake of CRC (colorectal cancer) screening. The reason for rising incidence in younger adults remains unknown,” said Rebecca Siegel, one of the study’s researchers and scientific director of surveillance research for the American Cancer Society. “The obesity epidemic is probably contributing, but doesn’t seem to be the sole cause. Diet has a large influence on colorectal cancer risk and there is a lot of research going on looking at how different things we consume, including drugs like antibiotics, influence gut health, specifically their role in determining the microorganisms that make up our microbiome.”



Colorectal cancer is the fourth most common cause of cancer death in both men and women in the U.S., according to the Centers for Disease Control and Prevention (CDC). The researchers said more than half of all cases and deaths are attributed to “modifiable risk factors” such as smoking, excess body weight, physical inactivity, high alcohol consumption and an unhealthy diet.

In 2018, the American Cancer Society updated its colorectal cancer screening guidelines, pushing the recommended age from 50 to 45. However, other organizations, including the U.S. Preventive Services Task Force, still advise screening to begin at age 50 and continue until age 75.

“Screening for colorectal cancer can identify and remove polyps before they progress to cancer,” said Kathy Cronin from the National Cancer Institute. “This is different than other cancer sites where screening detects early-stage cancer.”

The number of people younger than 50 years who died from colorectal cancer increased by 1.3% each year from 2008 and 2017, while death rates for individuals 50 to 64 years increased by half that rate — 0.6% — each year.

Meanwhile, death rates for those 65 years and older dropped by 3% annually during the same time frame.

For the study, the researchers pulled data from the National Cancer institute and the CDC to measure incidence and mortality trends.

The researchers found that the colorectal cancer patient population overall was “rapidly shifting younger,” noting the median age of diagnosis dropped from 72 years during the year from 1988 to 1999 to 66 years old during in 2015-2016.

“Young patients are diagnosed later and have unique challenges. For example, they are our most productive citizens and often juggling young families; they are often less financially able to cope with a cancer diagnosis, including being more likely to declare bankruptcy than older patients as a result of the diagnosis; and they are more likely to experience long-term effects of treatment, such as a second cancer,” Ms. Siegel said.

This year, the researchers estimate there will be 147,950 individuals newly diagnosed with colorectal cancer in the U.S., and 53,200 deaths, including 3,650 people (7%) younger than 50 years, from the disease.

“This study makes clear that colorectal cancer is no longer a disease of old age. Be aware that screening can save lives, and if you are over 50, you should be getting screened,” said Ronit Yarden, senior director of medical affairs for Colorectal Cancer Alliance. “Colorectal cancer is one of the most preventable cancers with routine screening — it’s also highly treatable if detected early through screening.”

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