Millennials have four times the risk of rectal cancer and double the risk of colon cancer compared to baby boomers. This is according to a new study published February 28th 2017 by researchers from the American Cancer Society. In this study published by the Journal of National Cancer Institute, colon cancer increased by about 1-2% per year and rectal cancer increased by 3% per year for people in their 20s and 30s between the mid 1980s and 2013. Three in ten new cases of rectal cancer are now diagnosed in individuals less than 55 years old. The rates for adults 55 and older have dropped for four decades.
The reasons for these increases are poorly understood. Increasing obesity, changes in food production and consumption, and more diagnostic tests have been cited as possible reasons.
Regardless of the reasons, the results of this study do not bode well for our nation’s health. This is why we must confront it now.
One, we need to raise public awareness about this trend and about colorectal cancer in general. Colorectal cancer is the 2nd leading cause of cancer deaths in the U.S. According to the American Cancer Society, 95,000 cases of colon cancer and 40,000 cases of rectal cancer will be diagnosed in 2017. And 50,000 people are expected to die from colorectal cancer in 2017. Death from colorectal cancer can be prevented. Colorectal cancer usually has a precursor lesion, colorectal polyps. In a study published in the New England Journal of Medicine in 2012, removal of polyps during colonoscopy led to a 53% reduction in colorectal cancer death.
Two, educate the public about symptoms of colorectal cancer. These symptoms are often dismissed in young people because colorectal cancer has always been considered the disease of the old. Young patients are 58% more likely to be diagnosed with metastatic colorectal cancer instead of localized cancer. Symptoms of colorectal cancer include blood in the stool, change in bowel habits (diarrhea or constipation), abdominal pain, abdominal fullness, and weight loss. Screening colonoscopy is recommended for average risk adults starting at age 50. High risk individuals including those with Lynch syndrome, polyposis syndrome, inflammatory bowel disease (ulcerative colitis, Crohn’s disease), and family history of colorectal polyps or colorectal cancer are advised to start sooner. Symptoms of colorectal cancer in young adults should prompt a visit to a physician and consideration for a diagnostic colonoscopy. The diagnosis of colorectal cancer in young adults should lead to genetic testing for Lynch syndrome. Lynch syndrome is an inherited condition that increases a person’s risk for colorectal cancer and other cancers.
Three, change in lifestyle. Obesity, smoking, alcohol, red meat, processed meat, and low fiber diet have been linked to colorectal cancer. A healthy lifestyle that includes exercise, avoidance of smoking, moderate alcohol use and high fiber diet is not only good for the colon; it is also good for the heart.
And lastly, improve access to medical care. Regardless of the politics of the affordable care act, access to medical care should remain a priority of policy makers. Funding for graduate medical education and biomedical research should remain a national priority.