Young people are at higher risk of colorectal cancer

Article written by Master, Doctor Mai Vien Phuong - Gastroenterologist - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital.

Colorectal cancer is the third most common cancer in men and women in the United States. It is the second leading cause of death from cancer. And according to many research data, the proportion of young people at risk of colorectal cancer is increasing.

Studies have identified more than 130,000 patients diagnosed with colorectal cancer under the age of 50. More than 1 million patients were diagnosed at age 50 or older. In people diagnosed under the age of 50, the number of cases between 2004 and 2015 increased.
Of all cases of colorectal cancer diagnosed, 10% are under the age of 50 (in 2004). That number rose to 12.2% in 2015. At the time of initial diagnosis, young patients were in the advanced stages of the disease - more than 50% were in stage 3 or 4.
Of those diagnosed under age 50, the incidence is higher in African-American (13.9%) and Hispanic (18.9%) populations.
A 2014 study published in the journal JAMA Surgery predicts that by 2030, the number of colon cancer cases among 20- to 34-year-olds will increase by 90% and rectal cancer will increase by 124.2 percent. .
Colorectal cancer is the third leading cause of cancer-related deaths in the US affecting both men and women, according to the Centers for Disease Control and Prevention. Even so, overall rates of new cancer diagnoses and cancer deaths across all ages have been steadily declining since 2009. Experts believe this is due to advances in screening and disease management.
Dr. Nancy You, associate professor of oncology surgery at the University of Texas MD Anderson Cancer Center, said that there are a number of factors contributing to the aforementioned reduction. “These are encouraging progressive trends and they reflect the collective achievements of our society as a whole. Previous modeling studies have shown that there are three main contributors: Advances in treatment, identification and modification of risk factors, and cancer screening practices.

Currently, it is not known why young populations develop colorectal cancer. Many people believe that colon cancer is caused by inherited cancer syndromes (i.e. inherited mutations in genes that predispose to cancer). But in the majority of patients, the cause is not clearly identified.
The American Cancer Society updated its guidelines for colorectal cancer screening in 2018. Prior to that, guidelines recommended screening begin at age 50 for people at average risk. However, new guidelines recommend screening at age 45.
The more people know about colorectal cancer, the more likely they will be to get screened. “There is a growing awareness of the importance of screening. Whether it's a stool test, a pelvic colonoscopy, or a total colonoscopy. I think for sure, social media awareness has also increased,” said Dr. Cathy Eng, co-leader of the VICC Gastrointestinal Cancer Research Program at Vanderbilt University Medical Center .
Screening tests are an important factor to consider in assessing the incidence of colorectal cancer. There are both stool-based and imaging tests available. Some fecal-based sampling methods include annual testing, others every three years. Imaging tests, including colonoscopy every 10 years and using computed tomography or sigmoidoscopy with flexible scope every 5 years. While there are many options, it's best to talk to your doctor to determine which test is right for you.
Although the study's authors did not have an exact reason for the increased incidence, they predicted a lack of screening. “Due to the lack of screening, younger patients are more likely to have and die from advanced disease.”

Colorectal cancer signs and symptoms can be complex and alarming. Being aware and alert to changes in the body is essential for detecting cancer in its early stages.
Here are some symptoms to watch out for:
Rectal bleeding. Changes in stool shape, including size and shape. Lose weight without dieting. You have to strain when you have a bowel movement. Fatigue or decreased stamina during exercise. Discomfort or the urge to have a bowel movement when there is no need. Bloating or feeling full. It is never too early to consider colorectal cancer risks and prevention measures.
“Historically, colorectal cancer affected people in their mid to late 60s. However, 15% of patients are under the age of 50,” said Dr. Cathy Eng. “An increase in colon and rectal cancers in young patients is expected over the next decade. This is a preventable cancer. Get checked out if you're of the right age or see your doctor if you have any of these symptoms. Early screening is better than no screening.”

The diagnosis of colorectal cancer can be daunting, but the reality is that this type of cancer is treatable, especially when caught early.
The 5-year survival rate for all stages of colon cancer is estimated at 63% based on data from 2009 to 2015. For rectal cancer, the 5-year survival rate is 67%. The 5-year survival rate reflects the percentage of people who survive at least 5 years after diagnosis.
According to the University of Texas Southwestern Medical Center, in 2015 the median survival time for stage 4 colon cancer was about 30 months. In the 1990s, the average was only 6 to 8 months.
At the same time, doctors are now seeing more colorectal cancer in younger people. One of the reasons could be an unhealthy lifestyle. According to the ACS, while the mortality rate from colorectal cancer decreased among older adults, among those under the age of 50, it increased from 2008 to 2017.

Certain risk factors for colorectal cancer, such as family history and age, are not preventable. However, lifestyle factors that can contribute to colorectal cancer are preventable and may help reduce the risk of developing the disease. There are a few things you can do to reduce your risk of colorectal cancer:
Reduce the amount of red meat you eat. Avoid processed meats, such as hot dogs and cold cuts. Eat more plant-based foods. Reduce fat in the diet. Daily exercise. Lose weight if your doctor recommends it. Quitting smoking . Reduce alcohol consumption. Reduce stress . Pre-existing diabetes management. Another preventative measure is to have a colonoscopy or cancer screening after age 50. The earlier cancer is found, the better the treatment outcome.
Colorectal cancer is completely curable if detected early, so screening for early detection of colorectal cancer is very important. When there are risk factors or suspicious symptoms, you should go to hospitals and specialized medical centers for screening to help detect colorectal cancer early.
Vinmec International General Hospital is a large hospital chain, the first general hospital in Vietnam to meet global medical standards. Currently, Vinmec is a leading medical facility in the field of colorectal cancer screening and detection.
Vinmec International General Hospital is one of the hospitals that ensures modern equipment, a team of doctors, good and experienced staff with leading professors and doctors at home and abroad. Preventive, advanced tests allow the implementation of the most advanced colorectal cancer screening techniques.