As colon cancer rates rise among young adults, doctors advocate for more screening

Cedar Rapids resident Zach Douglas was diagnosed with stage four colon cancer when he was 38 years old. Though uncommon, his case is part of a trend that's becoming more and more common across the United States.

Over the past three decades, the rate of colorectal cancer - or cancers of the colon and the rectum - has more than doubled among individuals under the age of 50, according to the National Cancer Institute.

Over the past several years, cancer rates in people under the age of 50 have risen 2.2 percent per year, according to the American Cancer Society. As a result, that age group accounted for about 12 percent of all colorectal cancer cases in the U.S. in 2020 with a total of about 18,000 cases.

However, even as cancer rates among young people are on the rise, rates among those aged 50 and older have decreased over that same three-decade period of time - largely because that age group was receiving recommended screenings, including colonoscopies, some research suggests.

As someone in his 30s who was presenting with symptoms but had no family history, Douglas's chances for cancer would have been considered rare years ago and he would not have been screened, said Dr. Dean Abramson, a gastroenterology specialist at UnityPoint Health-Cedar Rapids.

'This is someone who a decade ago would have been ignored a long time by primary care,” he said.

Taking that possibility into consideration is important, Abramson said, because young people are presenting with more aggressive, more progressed tumors than older patients. However, because of their age, they are also more likely to do well with treatment.

'So the time between the first complaint and their treatment is important,” Abramson said.

When Douglas first began having symptoms, including abdominal pain and blood in his stool, cancer was not initially considered as a possibility when he went to his doctor, he said. A month later, he went to urgent care with the same symptoms and health care providers thought it could be hemorrhoids.

But the symptoms continued to get worse and the pain in his abdomen became debilitating. He said on his third visit, the nurse practitioner immediately suspected cancer and ordered tests.

The results came back, and Douglas said he was given two years to live. Still, he said he was relieved to know what was wrong.

'Up until then, I had no idea what was going on with me, so at least I knew what was wrong and I could start treatment,” he said.

Douglas, now 40, has been receiving chemotherapy infusions for the past two years. He said his treatment will continue for the foreseeable future, until his cancer is in remission.

It's still unknown what's causing this increasing trend of colorectal cancer rates among young adults. Experts theorize it could be related to poor diet, since that age group tends to eat lower amounts of fiber and consume a higher amount of red meat and processed food. It could also be related to certain bacteria in the gut, which leads to inflammation that can be harmful, according to the National Cancer Institute.

Family history still is a very important risk factor when considering a possibility of cancer in a patient, Abramson said.

For those that don't have a family history or other symptoms, Abramson advocates to begin regular screenings at age 45, rather than the recommended age of 50. By doing so, doctors can catch patients sooner and even improve patient outcomes, he said.

Abramson recommended patients ask their doctors about starting their screenings sooner.

Signs and symptoms of colorectal cancer include a persistent change in bowel habits, weight loss, rectal bleeding or blood in the stool as well as abdominal pain or discomfort. If you notice persistent symptoms, reach out to your doctor about a screening.

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