Colon cancer - WKTV Journal

Researchers have seen colon cancer cases in young adults rise as much as 18 percent a year in some countries. (Courtesy Spectrum Health Beat)

The rise in colon cases among younger adults that’s been seen in the United States is also occurring in wealthier nations worldwide, new research shows.

In the decade leading up to 2014, the number of cases of colon cancer among people under 50 increased by 3% a year in Denmark, New Zealand, Australia and Canada and by 1% per year in Britain.

The increase was most pronounced among those aged 20 to 29, noted a team led by Dr. Marzieh Araghi, from International Agency for Research on Cancer in Lyon, France.

Among twenty-somethings, colon cancer cases rose by 18% a year in Denmark and 11% in Norway, according to the study published in The Lancet Gastroenterology & Hematology.

“Although the incidence of colorectal cancer in adults younger than 50 years remains much lower compared with that in older age groups, our findings are of concern and highlight the need for action to counteract the rising burden of the disease in younger people,” Araghi said in a journal news release.

The increase in cases among the young runs counter to declines in colon cancer among people over 50, the researchers pointed out.

For example, between 2004 and 2014 cases of colon cancer fell each year among people over 50—by 2% in Australia and Canada, 3% in New Zealand and 1% annually in the U.K.

Colon cancer remains a huge global killer.

According to the research team, in 2018 alone nearly 2 million cases of colon cancer were diagnosed and the disease claimed 881,000 lives worldwide.

But why the surge among the young? According to Araghi, the increase is likely driven in part by increases in certain risk factors, specifically obesity and poor diet.

On the other hand, he said, the decrease in colon cancer among people over 50 is most likely due to better screening stool tests or colonoscopy that catches tumors early.

Dr. David Bernstein is chief of hematology and a gastrointestinal specialist at Lenox Hill Hospital in New York City. Reviewing the new report, he said similar data has already changed medical practice in the United States.

“The U.S. findings have led to updated (American Cancer Society) colon cancer screening guidelines, which now recommend the initiation of colon cancer screening at age 45, as opposed to previous guidelines recommending the initiating of screening at age 50,” Bernstein noted.

Early screening and detection could bring colon cancer numbers down again among the young, he said.

Dr. Elena Ivanina is a gastroenterologist at Lenox Hill Hospital in New York City. She believes younger Americans need to pay more heed to avoiding colon cancer risk factors.

“This includes things like obesity, diet, smoking and other carcinogens,” she said. “Patients should discuss their colon cancer risk with their physician and not ignore any symptoms like rectal bleeding, no matter what their age.”

In the meantime, Bernstein said, “perhaps the more important question is ‘why in high income countries is the incidence of colorectal cancer increasing among young adults, and what factors are leading to this?’” Bernstein said. “Significant work needs to be done to answer this critical question.”

Reprinted with permission from Spectrum Health Beat.

Stop colon cancer in its tracks, early, with lifestyle changes and preventive screening. (Courtesy Spectrum Health Beat)

By Diana Bitner, MD, Spectrum Health Beat

Did you know your lifestyle choices could tip the scale for whether or not you experience cancer in your lifetime?

It’s true.

No one purposefully acts to increase their cancer risk, however, not everyone knows which lifestyle choices will make a negative—or positive—difference.

Take colon cancer, for instance. Colon cancer risk is affected by lifestyle habits and can be detected early if people are aware of their risk, get timely screenings and watch for early symptoms.

Studies show there are ways we can proactively reduce our chances of developing colorectal cancer.

People who exercise daily, eat a diet high in fiber, fruits and vegetables, take adequate vitamins B6 and D, and eat fish regularly (not deep fried) have a lower relative risk of getting colorectal cancer.

People who smoke, drink more than two alcohol drinks per day and are obese have a higher risk. Hormone replacement therapy, statins and daily aspirin are also shown to be associated with a lower risk of colorectal cancer.

Many women I have cared for never thought they would get colorectal cancer. Some women think it is an older person’s disease or that only men are at risk.

Risk factors for colorectal cancer

• 50 years or older

• HPV infection

• Family history of colorectal cancer

• History of Crohn’s or ulcerative colitis

• Diet high in saturated fats and low in fiber

• Diet low in vitamins D and B complex

• More than one alcoholic drink per day

• Lack of exercise

• Obesity

How cancer develops

Cancer happens when cells start to grow out of control either from exposure to a cancer-causing agent like cigarette smoke, or damage in the process of growth control like with BRCA gene mutations.

If there is both exposure and a gene mutation, the risk is even higher. When cells grow out of control, they group together in a lump or mass and then can break free of the organ boundaries, and spread.

The earlier a cancer is caught, the easier it is to treat. Once cancer spreads, it is much harder to cure.

A cautionary tale

A patient I’ll call Susan never thought colon cancer would affect her. In her case, there was no family history, no inflammatory bowel disease, and she lived a healthy lifestyle. She is active, rarely drinks alcohol, eats low fat and takes her vitamins.

But Susan had symptoms. She ignored those symptoms, thinking it must be a yeast infection, constipation, or simply not important. Like many of us, she was so busy caring for her family she didn’t make the time to get checked out.

Her pain worsened, the discharge worsened and her bowel habits started to change more dramatically. She finally had no choice but to pursue testing. Susan learned she had Stage 4, metastatic colorectal cancer.

Susan underwent aggressive surgery and chemotherapy with a good result. Her story is one that should make us all pause and remember to seek care when something does not seem right. Another takeaway: Get your colonoscopy.

Be proactive

Donald Kim, MD, is a Spectrum Health Medical Group colorectal surgeon and cares for patients with colorectal cancer.

“Colorectal cancer is not only treatable but preventable with proper colon cancer screening,” Dr. Kim said. “Unfortunately, most patients present without symptoms, so it’s essential that you have your recommended screening colonoscopy.”

If you have risk factors for colorectal cancer, it is important you not only get an early screening, but also follow a healthy lifestyle to reduce your chances of getting cancer.

Risk factors include being 50 or over (45 and over if African American), have a first-degree relative with colorectal cancer, have a family history of colorectal cancer or genetic syndromes such as familial polyposis syndrome or Lynch syndrome. It also matters if you have a personal history of colon polyps or inflammatory bowel disease such as Crohn’s colitis or ulcerative colitis, or if you have had abdominal radiation.

The symptoms of colorectal cancer depend on the location of the tumor. They include a change in bowel habits such as new constipation or diarrhea, consistent new bloating and gas, rectal bleeding or dark tarry stools, a feeling of incomplete emptying, or persistent cramps and pain. Another sign of cancer is iron-deficiency anemia.

Reprinted with permission from Spectrum Health Beat.