A troubling trend is emerging in colorectal cancer diagnoses: increasingly, the disease is being detected in younger adults. Once considered a cancer primarily affecting those over 50, colorectal cancer is now the leading cause of cancer death for people under 50 in the United States, according to a recent study. This shift is prompting concern among medical professionals and raising questions about the factors driving this rise and how to best protect a younger generation.
The statistics are stark. While mortality rates for many other cancers are declining in younger adults, colorectal cancer deaths in those under 50 have been steadily increasing – about 1 percent each year since 2005. By 2023, the disease surpassed all other cancers as the top cause of cancer-related death in this age group. This alarming rise is particularly noticeable in individuals in their 30s and even 20s, challenging conventional understanding of the disease’s typical onset.
A 27-Year-Old’s Story
Carolyn Vasquez of Oak Harbor, Washington, is one of those individuals. In 2018, at the age of 27, Vasquez was newly married and had recently returned home after serving in the Peace Corps in Paraguay when she began experiencing unexplained weight loss and persistent fatigue. “I was also beginning to notice blood in my stool,” she recalled. After multiple visits to urgent care and finally her primary care physician, an urgent colonoscopy revealed a devastating diagnosis: cancer in her rectum.
The initial diagnosis was stage 3, but further testing revealed the cancer had metastasized to her liver, upgrading the stage to 4. “The prognosis was not good. I believe I had a less than 20 percent chance of surviving this,” Vasquez said, but she credits her care team at Fred Hutchinson Cancer Center with providing exceptional support. She eventually connected with oncologist Dr. Stacey Cohen, who played a crucial role in her treatment plan.
Why the Increase in Young-Onset Colorectal Cancer?
Dr. Cohen, a professor of hematology and oncology at Fred Hutchinson Cancer Center specializing in colorectal cancer, describes the trend as “alarming.” “I would say it’s alarming that we’re seeing a consistent trend across the years that we have not seen that abate at all,” she stated. Current screening guidelines recommend that individuals at average risk begin colorectal cancer screening at age 45. However, Dr. Cohen emphasizes that many younger patients are not screened unless they exhibit symptoms.
“We don’t screen patients under 45 unless they have some kind of symptom. I hear day in and day out about young patients who did have a change in bowel habits or blood in their stool or abdominal pains, and they might have even saw their providers and told them about these symptoms. But often young patients are told it’s one of a more common symptom, like IBS or hemorrhoids, and they don’t actually get checked out,” Dr. Cohen explained.
The exact causes of this increase in young-onset colorectal cancer remain unclear, but researchers are exploring several potential factors. These include dietary habits, exposure to environmental toxins like microplastics, and alterations in gut bacteria due to antibiotic use. More research is needed to fully understand the complex interplay of these elements.
Navigating Treatment and Advocating for Change
Vasquez underwent five surgeries and multiple rounds of chemotherapy. Now 34 years old, she has remained cancer-free for five years and is pursuing a career as a physician assistant at the University of Washington. She is driven by a desire to advocate for patients, mirroring the support she received from her own doctors. “My anatomy is just kind of different now. And so I do deal with those side effects every day, but overall I do feel good on a daily basis,” she said.
Vasquez urges anyone experiencing concerning symptoms to be proactive and open with their healthcare providers. “Just be open with your healthcare providers about symptoms that you’re having. Be honest about them. Don’t be embarrassed by anything,” she advises. Dr. Cohen reinforces this message, emphasizing that without specific screening, colorectal cancer is unlikely to be detected during routine checkups.
March is Colorectal Cancer Awareness Month, and Fred Hutchinson Cancer Center will host a free community educational event on March 7 at 10 a.m. At the Matt Griffin YMCA. More information about the event can be found here.
The rising incidence of colorectal cancer in younger adults underscores the importance of increased awareness, early detection, and continued research. As medical professionals work to unravel the causes of this trend, individuals are encouraged to be vigilant about their health and advocate for themselves when experiencing potential symptoms. The next step in addressing this public health concern will be a deeper understanding of the risk factors and the development of more effective screening strategies for younger populations.
Have you or a loved one been affected by colorectal cancer? Share your thoughts and experiences in the comments below. Please also share this article to help raise awareness about this important health issue.
