According to a report published Monday by the American Cancer Society, an increase in rectal cancer rates is driving an increase in colorectal cancer diagnoses among people younger than age 65.
Colorectal cancer rates are increasing among people under the age of 65, with nearly half (45%) of new diagnoses occurring in this age group, up from 27% in 1995. At the same time, colorectal cancer rates are declining among people age 65 and older.
However, rectal cancers are increasing among all adults and now account for nearly a third of all colorectal cancer diagnoses, up from 27% in the mid-2000s, the report found.
Between 2018 and 2022, rectal cancer diagnoses will rise by 1% each year in all age groups.
Researchers don’t understand why this particular type of cancer is spreading.
“We didn’t have an epidemic of young people with colon or rectal cancer until recently,” Dr. said Arif Kamal, chief patient officer of the American Cancer Society. “It’s really been a phenomenon in the last five years or so that we’ve started to see it.”
The report found that colorectal cancer rates since the late 1990s were:
- For people aged 20 to 49 years it increases by 3% every year
- For adults aged 50 to 64, the rate increases by 0.4% each year
- For adults 65 and older it decreases by 2.5% each year.
The shift toward younger adults with colorectal cancer is prompting doctors to urge earlier education about a disease that, for generations, occurs only at older ages.
“We know that younger patients are presenting with signs and symptoms, and there’s a gap of about 4 to 6 months between symptom presentation and diagnosis, which is alarming,” said Andreana Holovatiz, M.D., assistant professor of hematology and oncology at Vanderbilt University Medical Center. “How do we educate Gen Zers, Millennials and future generations? Holovatiz was not involved in the new research.
What are the symptoms of rectal cancer?
Colorectal cancer includes cancer of the large intestine, most of which is the colon. The rectum is found at the very end of the large intestine before the anus.
Tumors in the rectum cause “slightly more dramatic” symptoms compared to tumors in the colon, Kamal said.
Colon cancer symptoms can be vague, including fatigue, abdominal pain, bloating and unexplained weight loss. Rectal cancers are often accompanied by bright red blood on the toilet paper or toilet bowl and a real urgency to use the bathroom even after a bowel movement.
“While we don’t know the drivers of the rise in rectal cancer, it underscores the importance of knowing your body and reporting symptoms to your doctor early,” Kamal said.
When should people start screening for colorectal cancer?
Until recently, colorectal cancer screening was only recommended for people 50 and older. In 2021, the US Preventive Services Task Force lowered the screening age to 45.
Some people are at high risk for colorectal cancer and should be considered for earlier screening, according to current guidelines. Included are people with a family history of the disease or people with preexisting polyps or inflammatory bowel disease.
According to a new report, however, less than one-third of 45- to 49-year-olds are getting screened. About three-quarters of colorectal cancers in people under the age of 50 are diagnosed after the disease has progressed to an advanced stage.
Now that colorectal cancer diagnoses are trending younger, the recommended age for screening may need to be reconsidered, Kamal said.
“Decisions will be taken in the next two years for sure,” he said.
Caitlin Murphy, a cancer epidemiologist at the University of Chicago, said there is growing interest in “fast-tracking” people under 45 who develop symptoms suggestive of colorectal cancer.
“Patients get stuck in referral loops where they get referred to this person, who then gets referred to this person, and so on for months,” said Murphy, who was not involved in the new report. “We want to make sure people get timely treatment, so the cancer doesn’t progress while they’re waiting for a diagnosis.”
How to reduce the risk of colorectal cancer
Colorectal cancer is the nation’s No. 1 cancer-related death in people under the age of 50. 1 reason. A new report estimates that 158,850 new colorectal cancers will be diagnosed in 2026. About 55,230 patients die from the disease, one-third of which are under the age of 65.
Researchers link more than half of colorectal cancer to controllable risk factors: smoking, high alcohol consumption, lack of exercise and excess body weight.
Making dietary changes, including increasing your intake of fiber, vegetables, fruit and whole grains and cutting down on processed meats, can reduce the risk, according to the American Cancer Society.
