You might not think too much about colorectal cancer if you haven’t celebrated your 45th birthday yet. That’s the recommended age for starting screening if you’re at average risk. But there are some crucial things about colorectal cancer younger people should know.
Overall, colorectal cancer is declining in the United States. That’s because more people are being screened for it, and screening tests can catch precancerous polyps that can be removed before they turn cancerous.
But it’s older people who are driving that decline. The rate of colorectal cancer is rising in adolescents and young adults and it’s not clear why. Madappa Kundranda, MD, a medical oncologist with Banner MD Anderson Cancer Center at Banner Gateway Medical Center, shared these concerning statistics—newly diagnosed colorectal cancer is up 6% in people under age 45 and up about 20% in people younger than 55.
How to reduce your risk for colorectal cancer
It’s not possible to eliminate your risk, but these steps can help you reduce it:
- Get at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise each week.
- Eat a plant-based diet—fill two thirds of every meal with whole grains, vegetables, fruits, nuts and seeds, and fill the remaining one third with lean protein like chicken, fish or tofu.
- Eat no more than 18 ounces of red meat per week. Three ounces is about the size of a pack of cards.
- Limit processed meats like bacon, hot dogs and deli meats.
- Maintain a healthy body weight. Excess fat increases the risk for colorectal cancer.
- Limit alcohol. For cancer prevention, it’s best not to drink alcohol.
- Avoid tobacco.
What symptoms should you watch for?
A lot of the symptoms of colorectal cancer can be caused by other conditions such as hemorrhoids. See your health care provider if any of these symptoms last for more than two weeks, even if you’re a teenager or young adult:
- Diarrhea or constipation that does not go away
- Change in your bowel habits, such as size, shape or frequency
- Discomfort or urge to have a bowel movement when there is no need
- Rectal bleeding
- Blood in your stool or toilet after a bowel movement
- Abdominal pain, cramping in your lower stomach or weakness
- Feeling bloated or full
- Change in appetite
- Unexplained weight loss
- Fatigue, low stamina or more exhaustion than normal
Should younger adults be screened?
If you have a parent, child or sibling diagnosed with colorectal cancer or precancerous polyps, you may be at higher risk, especially if your relative was diagnosed before age 45. Your risk is even higher if you have more than one family member with colorectal cancer.
If you have a family history of colorectal cancer or precancerous polyps , talk to your doctor about the recommended age to begin screening exams and about how often you should be screened.
How do you screen for colorectal cancer?
Colonoscopy is the recommended screening method, but it’s not advised for people under age 45 at average risk. However, your doctor might prescribe a colonoscopy if you have a family history of the disease or your symptoms are concerning.
Other screening tests are available, including virtual colonoscopy, fecal immunochemical tests, stool DNA tests and flexible sigmoidoscopy, but colonoscopies are usually recommended for younger people who need screening.
During a colonoscopy, your doctor looks for colon cancer and polyps in the lining of the colon by inserting a scope through your rectum while you are sedated. Some may be apprehensive about the procedure, especially the bowel prep, which involves restricting your diet and drinking a large volume of prescribed liquid laxative to flush out the colon and rectum. Thankfully, there are ways to make the prep for colonoscopy smooth and bearable.
How is colorectal cancer treated in younger people?
Most people need surgery, and some may need chemotherapy or radiation therapy. Adolescents and younger adults with colorectal cancer tend to be diagnosed at more advanced stages, so many doctors believe they may experience worse outcomes and recommend more aggressive therapies. But Dr. Kundranda doesn’t think that’s always the right approach.
“There’s no data to support more aggressive treatments in all younger people,” he said. “Treatment should be individualized.” He pointed out that newer therapies are available, and tumor profiling can help identify the best options for younger people.
Younger people are more likely to live with the complications that can come from cancer treatment for a longer time. So, when they and their doctors are considering treatment options, they need to keep in mind the potential for things like altered digestion, peripheral neuropathy, sexual dysfunction, fatigue and the risk of additional cancers.
Younger people who plan to have children could face infertility after treatment, so they may need to decide whether they want to freeze eggs or sperm.
The bottom line
Colorectal cancer is on the rise in younger people, and it’s often diagnosed at a more advanced stage. So younger people with a family history of the disease or who experience concerning symptoms for more than two weeks should talk to a health care professional.
Have concerns about symptoms of colorectal cancer?
Schedule an appointment with a primary care provider near you.