Colorectal Cancer Rising Among Younger Americans As Rates Fall For Others


By Dr. Nina Radcliff

Colorectal cancer is one of the most preventable cancers and at the same time the nation’s second-leading cause of cancer deaths of men and women. And, too, there are gender differences. Men have an increased incidence of colorectal cancer and are more likely to develop it at an earlier age and die from it. Colorectal screening procedures have an important role in preventing and treating colorectal cancer – yet, screening rates remains inadequate.

A disturbing fact has come to light about colorectal cancer in a recent study by the American Cancer Society revealing that there has been a steady increase of incidence in every generation born since 1950. And so while the overall incidence of colorectal cancer continues to decline and too, while younger adults have a comparably low risk compared to those over the age of 50 years of age – younger adults’ risk of colorectal cancer today is higher than it has been for past generations, at the same age.

News of this trend has caused a lot of speculation on how younger generations should prepare for this problem and whether or not the medical community should change standards for screening. Interestingly too, most of the young people in the study, that were diagnosed with colorectal cancer did not have a family history and their cases were considered to be sporadic. Experts don’t entirely know the reason for that, but there’s some supposition that it’s related to dietary changes, exercise changes, obesity and any number of other health factors. 

Across all ages, what health professionals and experts are in agreement with is that in the fight to prevent, treat, and manage colorectal cancer, it is important to know the symptoms and if possible your family history and to seek medical help. Again, if caught early, these types of cancers are very treatable.

Dr. Nina’s What You Need To Know About Colorectal Cancer

What is colorectal cancer?

Cancer describes abnormal, uncontrollable cell growth. And colorectal cancer is a cancer that originates in the colon (intestine or large bowel) or rectum (connects the colon to the anus).     

What are some non-modifiable risk factors for colorectal cancer?

  • Age—Although it can occur at any age, according to the Colon Cancer Alliance, 90% of new cases occur in people 50 or older; and the median age of diagnosis in men is 68 years and in women 72 years.
  • Ethnicity and race—African Americans and Jews of Eastern European descent have an increased risk of developing colorectal cancer
  • Family history of colon polyps, colorectal cancer—in particular when it is a first-degree relative and, too, if they are diagnosed at a young age
  • Inflammatory bowel disease—ulcerative colitis or Crohn’s disease

What are warning signs for colorectal cancer?

During early stages, there are few, and oftentimes no, symptoms. And, too, warning signs are non-specific for colorectal cancer (in medicine this means the sign or symptom is not assignable to a particular cause, condition, or disease). They include:

  • Change in bowel habits (diarrhea, constipation) that lasts longer than 4 weeks
  • Narrower than usual stool 
  • Rectal bleeding, or blood in the stool
  • Persistent gas, abdominal pain, bloating, feeling full, or cramps
  • Unexplained weight loss
  • Weakness or fatigue
  • Nausea or vomiting

If you are experiencing these, it is important to consult with your healthcare provider so they can help decipher the cause and if further testing is needed.


Why is early detection crucial?

Colorectal cancer is considered one of the most preventable cancer and, too, highly treatable. Being vigilant, with appropriate screening is key to catching and removing polyps (pre-cancerous growths) inside the colon and rectum. Additionally, if cancer is present, the earlier it is detected, the greater the chances of survival.


What screening tests are available?

There are a number of options and you should decide which one is best for you with your healthcare provider. The most common screening test is a colonoscopy—a procedure that allows your gastroenterologist doctor to examine the inner lining of your rectum and colon, take biopsies (tissue samples), and even remove polyps.

What are current colonoscopy screening guidelines?

Regular colonoscopy screenings in people without risk factors should begin at age 50 and age 45 in African Americans. If risk factors are present, it is important to discuss with your doctor if you should begin screening at an earlier age.

Repeat screening is performed every 7-10 years until the age of 75 in those with a negative test. Abnormal tests require more frequent screening (and, too, risk factors may mean more frequent screenings).

What should I expect from a colonoscopy?

Prior to your colonoscopy, intravenous fluids are started to provide hydration and allow for sedative medications to be administered. You will be placed on monitors that continuously display your heart rate and rhythm, blood pressure, and oxygen levels. Supplemental oxygen is delivered via a nasal cannula or mask.

What preventative actions should be taken?

While you cannot change your genes, and in some cases, your environment    you do have control over your lifestyle (and the choices you make), what we call “modifiable” risk factors.

A healthy lifestyle is key in prevention.

  • Eat a well-balanced diet with plenty of fruit and veggies that contain fiber, vitamins, and nutrients. Studies have shown that doing so can decrease your risk for colorectal cancer as well as a number of other cancers.
  • Reduce consumption of processed and sugary foods as well as red meat
  • Stop smoking (or don’t start) – no amount of smoking is good for you
  • Maintain a healthy weight
  • Be physically active – if you are sedentary or don’t move much, start taking a walk around the block and do it for a week or two and then make it 2 blocks. Start moving!
  • Avoid heavy use of alcohol

It’s important that families discuss their medical histories with each other. In some situations, families don’t like to talk about these issues but it’s important to share the information so that the next generation knows and can be properly evaluated. And, for anyone at any age, when discussing care with your doctor, it is important to be very forthright about any problem. Talk to your doctor about screening.  Timely screening and early detection when signs appear allows for early detection. The key with any cancer – but particularly colorectal cancer – is finding it at an early stage.

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