Colorectal cancer affecting younger patients as doctors warn of possible lifestyle factors

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One local patient, after being diagnosed with stage IV colorectal cancer at 44 in December 2022, has been advocating for more research on what is causing this trend as doctors speculate diet and environmental factors may be behind this change.

“It was a complete shock,” said Jessica Fox of Dayton, who didn’t have any symptoms until about 10 days before her diagnosis.

Fox, who had a healthy lifestyle and no known family history of colorectal cancer, had to undergo emergency surgery after learning her stage IV cancer had metastasized to her liver.

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“I was told that I had six months or less to live if they didn’t start treatment right away,” Fox said.

Fox has been on chemotherapy continuously since January 2023.

“It certainly makes me think our screening ages need to become even younger,” Fox said.

Overall, the incidence rate of colorectal cancer is going down due to increased screenings through colonoscopies and other methods, said Dr. Minia Hellan, a surgical oncologist at Kettering Health.

However, doctors are seeing an increase of about 2 to 3% yearly in those below 55 years old, she said. This has been happening since the mid-1990s, according to the American Cancer Society.

“This is a true increase in the young patient population,” Hellan said. “That is something we have not seen in the past. That is something that is really a big problem because we’re seeing more and more patients in their 40s and early 50s with colorectal cancer.”

It is important to diagnose colorectal cancer at its earlier stages, Hellan said.

“Colorectal cancer is very highly treatable and survivable, but it depends on the stage you find it in,” Hellan said.

The earlier colorectal cancer is detected, the higher the cure rate is, she said.

“Colon cancer is the second-leading cause of death in the U.S., and it’s the third most common diagnosed cancer,” said Dr. Piyush Patel, a medical oncologist and hematologist at Premier Blood and Cancer Center.

This phenomenon is not just happening in the U.S., as colon cancer is the second-leading cause of cancer-related deaths worldwide, according to the World Health Organization. The incidence rates were highest in Europe, Australia and New Zealand, and the mortality rates were highest in Eastern Europe.

Doctors speculate that diets low in fiber and vegetables, while being higher in processed food and red meat, may be impacting patients, Hellan said. Sedentary lifestyles, obesity and diabetes can also increase the risk of colorectal cancer, she said.

African Americans are also about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups, according to the American Cancer Society.

Family history and conditions like inflammatory bowel disease can be other risk factors, Hellan said.

“We don’t have a 100% answer as to why we’re seeing so many of the younger patients now,” Hellan said.

Research into gut health, including microbiomes or gut biomes―which are microorganisms living in the digestive tract―has shown that antibiotics can change the biome in the gastrointestinal tract, Hellan said.

“You lose the good bacteria, and the bad bacteria can overgrow,” Hellan said. She suggested more research could be done into gut biome and the bacteria people naturally have in their colons.

Patients like Fox are calling for more research to be done in general to see why younger people are getting diagnosed with colorectal cancer, she said.

Fox was recently in Washington, D.C. with the advocacy organization Fight Colorectal Cancer, also known as Fight CRC, to promote the need for more funding to go toward research and screenings, as well as to get legislators to sign up for the Colorectal Cancer Caucus.

“When they’re getting diagnosed, they’re getting diagnosed with more advanced stage disease, as myself,” Fox said. “There’s this increasing population of younger folks that are being diagnosed with more serious disease, so I think there’s just a lot of research that needs to done into why this is happening.”


By the numbers

In 2020, more than 1.9 million new cases of colorectal cancer and more than 930 000 deaths due to colorectal cancer were estimated to have occurred worldwide, according to the World Health Organization.

By 2040, the burden of colorectal cancer will increase to 3.2 million new cases per year worldwide, which is an increase of 63%, and 1.6 million deaths per year, which is an increase of 73%, the WHO says.

In the U.S., African Americans are about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups.

The American Cancer Society’s estimates for the number of colorectal cancers in the U.S. for 2024 are:

● About 106,590 new cases of colon cancer (54,210 in men and 52,380 in women)

● About 46,220 new cases of rectal cancer (27,330 in men and 18,890 in women)

From 2011 to 2019, incidence rates dropped by about 1% each year, mostly in older adults. In people younger than 55 years of age, rates have been increasing by 1% to 2% a year since the mid-1990s.


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