Colon cancer is striking younger American adults with greater frequency, and more tumors are being detected in advanced stages, worrying shifts in the occurrence of the potentially lethal disease that are sparking calls for wider screening and prevention measures.
About 20% of people with colon cancer in 2019 were under the age of 55, almost double the rate seen in 1995, according to a report from the American Cancer Society. Three out of five of Americans found to have colon cancer in 2019 were in the advanced stages of the disease, up from just over half in the mid 2000s, according to the report.
“It’s alarming to see how rapidly the whole patient population is shifting younger,” Rebecca Siegel, the group’s senior scientific director of surveillance research and lead author of the report, said in a statement. “The trend toward more advanced disease in people of all ages is also surprising and should motivate everyone 45 and older to get screened.”
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Colon tumors are the No. 2 cause of U.S. cancer death, with more than 153,000 cases and 52,000 deaths expected this year. Of those, some 20,000 cases and 4,000 deaths will occur in people under the age of 50, highlighting the importance of screening that can lead to earlier treatment, as well as prevention.
“About 55% of colorectal cancers can be attributed to risks that can be modified,” said Karen Knudsen, chief executive officer of the cancer society. The first steps for many people may include weight loss, increased exercise, avoiding smoking and eating a healthy diet, she said.
It’s unclear what’s causing the shift to earlier onset and advanced-stage diagnoses, and further investigation into the rising trends is needed. The incidence of colon cancer declined rapidly in people 50 and older during the early 2000s, largely because of an increase in the use of colonoscopies that can prevent advanced disease by removing precancerous polyps. While people over the age of 65 have continued to show progress over the past decade, colon cancer diagnoses have increased about 2% a year among people younger than 55, according to the report.
The American Cancer Society lowered the recommended age to begin colon cancer screening to 45 years, down from 50, in 2018, and the US Preventive Services Task Force—an independent, volunteer panel of national experts—followed up with a similar recommendation in 2021. People at higher risk because of environmental, behavioral or inherited factors may need even earlier screening and should consult with a doctor, Knudsen said.
The report drew on data from population-based cancer registries and the National Center for Health Statistics.