Increasing Incidence of Colorectal Cancer Among Teens and Young Adults

While the overall incidence of colon cancer in the United States has steadily declined over the past three decades, a concerning surge has been observed in younger populations for reasons not yet fully understood.

Colorectal cancer diagnosed in individuals under 50 is classified as early-onset colorectal cancer. Since the early 1990s, the U.S. has seen nearly a twofold increase in these cases, a pattern mirrored in several other countries.

In 1994, the early-onset colorectal cancer rate was 4.8 per 100,000 people, escalating to 10.1 per 100,000 by 2021.

Experts suggest that a combination of lifestyle and environmental factors—such as shifts in diet, rising obesity rates, and decreased physical activity—may be fueling this increase.

Continue reading to uncover more about the potential causes behind this alarming trend.

What Factors Are Driving the Rise in Colon Cancer Among Young Adults?

Colon cancer is now the leading cause of cancer-related deaths among adults aged 20 to 49, with incidence rates continuing to climb.

Early-onset colorectal cancer often presents as more aggressive and advanced compared to cases in older adults.

Currently, about 10% of new colorectal cancer cases in the U.S. occur in younger adults, with projections estimating this could rise to 25% within the next decade.

According to National Cancer Institute SEER data, here’s how incidence rates have shifted since 1994:

Despite the rise in younger adults, most colon cancer cases are not linked to family history.

Sporadic vs. Inherited Colon Cancer

Colon cancer is termed sporadic when it occurs without inherited genetic mutations associated with cancer.

Approximately 70% of colorectal cancers are sporadic, 25% are linked to inherited genes, and 5% are associated with inherited syndromes like Lynch syndrome or familial adenomatous polyposis.

In young adults, most colorectal cancers appear to be sporadic, likely influenced by lifestyle changes over recent decades.

Obesity is a well-established risk factor. A 2018 study showed women with obesity had a 20% higher risk of early-onset colorectal cancer compared to those without obesity.

Research from 2017 indicated that excess body fat before age 30 increases colon cancer risk, possibly due to inflammatory molecules called cytokines and persistently high insulin levels promoting cancerous changes.

Diabetes is also consistently linked to increased colorectal cancer risk and may contribute to early-onset cases.

A 2020 study revealed that individuals with diabetes reach the colorectal cancer risk level of non-diabetics at age 50 by age 45.

Who Is at Greater Risk for Early-Onset Colon Cancer?

Researchers continue to investigate risk factors for early-onset colorectal cancer, with varying degrees of evidence supporting each.

Key risk factors include:

Additional potential risk factors include metabolic syndrome, dyslipidemia, hypertension, and dietary habits such as high sugar, red or processed meat, and fat intake.

Conversely, diets rich in fiber, dairy, fruits, vegetables, fish, beta-carotene, vitamins C, D, E, and folate are linked to lower colorectal cancer risk.

Recognizing Colon Cancer Symptoms in Young Adults

Symptoms of colorectal cancer often resemble other gastrointestinal disorders like Crohn’s disease or irritable bowel syndrome but tend to worsen as the disease progresses.

Early warning signs may include:

• Abdominal pain
• Rectal bleeding
• Diarrhea
• Iron deficiency anemia

Other symptoms to watch for are:

• Constipation
• Narrow stools
• Feeling of incomplete bowel evacuation
• Black stools
• Abdominal bloating or lumps
• Rectal pressure
• Loss of appetite
• Nausea and vomiting
• Anemia
• Fatigue and weakness
• Unintentional weight loss
• Bowel obstruction

If cancer spreads, additional symptoms such as bone pain, jaundice, or shortness of breath may occur.

Preventing Colon Cancer: What You Can Do

Both genetics and lifestyle influence colon cancer risk. While prevention is not always possible, adopting healthy habits can reduce your chances.

• Engage in regular physical activity
• Maintain a healthy body weight
• Follow a diet low in animal fats and rich in whole grains, fruits, and vegetables
• Limit alcohol intake
• Avoid tobacco use

Health authorities recommend routine colon cancer screenings to detect disease early.

Screening Recommendations for Young Adults

The U.S. Preventive Services Task Force and American Cancer Society now advise starting colorectal cancer screening at age 45 instead of 50. Those with a family history may need screenings beginning at age 40 or 10 years before the earliest diagnosis in their family.

Summary

Despite overall declines in colon cancer rates, cases among young adults are rising significantly. Contributing factors may include obesity, dietary shifts, and reduced physical activity.

Early detection is critical for better outcomes, so consult your healthcare provider if you experience unexplained gastrointestinal symptoms such as abdominal pain or blood in the stool.

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