Research shows a sharp increase in colorectal cancer in younger adults. Dr. Steve Akman, medical director of Roper St. Francis Cancer Care discusses the findings and local trends.
Young folks, listen up. The American Cancer Society (ACS) has made headlines this month (Colorectal Cancer Awareness Month) with new data that shows a sharp increase of colorectal cancer in adults as young as their 20s and 30s. While typically considered a disease for older adults, this new study, covered widely by the media, found the proportion of cases diagnosed in adults age 50 or under has increased to 11 percent in 2013, up from six percent in 1990.
The good news is that colon and rectal cancer rates have dropped steadily for people born before 1950, but it is alarming, and puzzling to doctors, that colorectal cancer incidence has been increasing for every generation born since 1950. The ACS estimates that some 13,500 Americans under 50 will be diagnosed with colon and rectal cancer—and keep in mind that these patients would not routinely be screened, since the current recommended age for an initial screening colonoscopy is 50.
“We are seeing similar findings locally,” says Dr. Steve Akman, medical director of Roper St. Francis Cancer Care. The RSF cancer registry tracks all cancer diagnoses and outcome data for our health system. “Our data shows that 25% of all of our colorectal cancer patients for the past three years were age 55 or younger. This is consistent with the increased number of younger patients reported in the recent study published in the Journal of the National Cancer Institute,” says Dr. Akman. “And it suggests that younger people need to be better aware of the tip-offs and symptoms of colorectal cancer.”
These clues can include rectal bleeding or blood in the stool, pain or discomfort with bowel movements, unexplained weight loss, fatigue and any persistent change in digestive or bathroom issues.
Why is awareness so important?
The reason is straightforward. The earlier stage at which a colorectal cancer is detected, the better the outcome. That’s why screening is also important. Dr. Akman recommends that people become familiar with current national colorectal cancer screening guidelines and follow through with screening if they meet the recommended criteria for screening.
Also, Dr. Akman suggests, “know your family medical history.” If you have a first degree relative with a history of colorectal cancer before age 60 or two first degree relatives diagnosed with colon cancer at any age, the guidelines for screening set forth by the National Comprehensive Cancer Network (NCCN) begin earlier, at age 40 or at least 10 years before the relative’s age of onset. Also those with a hereditary (familial) syndrome known to be linked to colorectal cancer should consult a medical geneticist for screening guidelines. In addition, NCCN guidelines recommend that adults with a history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease) begin colonoscopy screenings after 8-10 years of active disease, regardless of age.
“In general, South Carolina is ahead of the national curve in terms of numbers of people who meet screening guidelines who actually get screened (60%),” says Dr. Akman. But RSF Cancer Care is participating in a national program to bump that even higher, to 80%. “We’ve established the Hank and Laurel Greer Colorectal Cancer program with a mission of increasing colorectal cancer screening in our region, particularly for underserved populations,” he notes.
Best Treatment is Prevention
For colorectal cancer, as with any disease, the best treatment is prevention, Dr. Akman stresses. “Primary prevention includes eating a proper diet, getting regular exercise and controlling your body weight—these all favorably impact reducing the risk of colorectal cancer.” Secondary prevention can include using medication, such as anti-inflammatory agents, to decrease the risk of colon polyps.
And for patients who are diagnosed with colorectal cancer, expert care is at hand. “Roper St. Francis is a leading center for treatment and robotic surgery for colorectal cancer,” Dr. Akman says.