A recent study shows that even though rates of colon cancer are holding steady or declining among older adults, the rates of early-onset colon cancer are rising in many high-income countries. According to a report published in Gut, this trend of colon cancer in younger adults began around the mid-1990s.
Co-author and scientific director of surveillance research at the American Cancer Society, Rebecca Siegel, said that the new findings mean that "if you have symptoms consistent with colorectal cancer, you should follow up with a physician no matter what your age is. The most common symptoms in young people, based on our surveys, are the same as in older patients: constipation, blood in the stool or rectal bleeding, bloating, diarrhea, more narrow stool than usual, gas, pain, cramping."
Don't be alarmed if you experience any of these symptoms for just a day or two. "But if you have these symptoms for two to three weeks, then get it checked out," Siegel said.
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Siegel, as well as her colleagues, analyzed global data to find out why early-onset colon cancer appears to be increasing in the United States. "And there is a common thread," Siegel said. "So now we can point to some clues."
It "only seems to be happening in high-income countries and it started around the mid-1990s when something changed in terms of exposure. It's probably a combination of things that started to change the risk for the disease," Siegel said.
Siegel believes one likely cause is dietary changes. "The food supply changed immensely in the last half of the 20th century. While it's almost like looking for a needle in a haystack, there have been at least a couple of studies looking at sugar-sweetened beverages that found even moderate consumption increases risk. And it's not just sugar-sweetened beverages, but also high fructose corn syrup with a positive association. High glycemic load carbohydrates can create a highly inflammatory environment in the gut," added Siegel.
From 2008-2012, the following countries with high-quality cancer registry data reported the lowest colon cancer rates among people aged 20-49:
- India (3.5 per 100,000)
- Uganda (3.8 per 100,00)
- Chile (3.8 per 100,000)
The highest number of reports came from :
- Korea (12.9 per 100,000)
- Australia (11.2 per 100,000)
- United States (10.0 per 100,000)
- Slovakia (10.0 per 100,000)
Other countries including Canada, Denmark, Germany, New Zealand, Slovenia, Sweden and the UK also reported increases of early-onset cancer. The steepest increases were seen in New Zealand (4% annual increase) and Korea (annual increase 4.2%).
While rates of colon cancer among older adults were declining, rates of early-onset disease were increasing in New Zealand, Australia, Canada, and the United States.
Dr. Edward Chu, a cancer specialist and deputy director of the UPMC Hillman Cancer Center at the University of Pittsburgh School of Medicine said: "We're seeing a pretty significant increased incidence among those aged 40 to 49. They also tend to have much more aggressive disease and tend not to do well even with aggressive treatments."
Doctors used to attribute "abnormal GI symptoms in younger patients to benign causes, you can no longer blow these symptoms off. You have to be vigilant and more aggressive in trying to determine the causes of those symptoms," Chu said.
Chu concluded by saying that colon cancer can be "a silent disease." It's important to focus on prevention which means living a healthy lifestyle. "Cut down on red meat, increase fruit, vegetable and fiber consumption," he added. "Try to be physically active, don't smoke, and lose weight if you're overweight."
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