Under 50? You Need to Think About Colon Cancer, Too

Overall, fewer and fewer people have been dying from cancer — yet there are a few types of cancer that are instead starting to impact more people. 

This is especially true for colorectal cancer, which has been rising rapidly among adults under age 50. So rapidly, in fact, that it’s now the top cause of cancer-related death in men and the second in women in this age range. 

“We’re increasingly seeing patients who are younger and younger being diagnosed and dying from this disease,” says Dr. Mukta Krane, section chief of colorectal surgery at UW Medicine. 

You may be wondering: Why are more young adults getting colon cancer? What are the symptoms and early signs? What is the colorectal cancer survival rate? We have answers to these questions and more.  

Why are more young people getting colon cancer? 

As to why more millennials and Gen Xers are getting colon cancer, well, doctors don’t know yet. They suspect obesity, less-nutritious diets and detrimental changes in the gut microbiome could be at play.

“It’s more common in patients over age 50, but we have seen a trend recently with a higher incidence in the younger population,” Krane says. 

Although that primarily means people in their 40s, Krane has had patients in their 30s and even 20s.  

Oddly enough, while younger people are less likely to get colon cancer overall, their risk as a population is increasing significantly — whereas the overall risk for older people is noticeably decreasing. 

The American Cancer Society estimates that, by the end of 2024, there will be at least 259,000 new cases of colorectal cancer and more than 53,000 deaths. Colon cancer is currently the third most common cancer in the country for all genders, not including skin cancers.

What are symptoms and early signs of colon cancer? 

Here’s another unfortunate fact: many early stages of colon cancer don’t have noticeable symptoms, Krane says. 

Symptoms to watch for include rectal bleeding; a change in the size or shape of your stool, such as if it gets narrower; a change in bowel habits, like suddenly getting regular constipation or diarrhea; dark poop or blood in the stool; pain or cramping in the stomach; feeling weak or tired; and unintended weight loss.

Some of these symptoms can also be caused by colon polyps, which are clusters of cells that form in the lining of the colon. Polyps themselves aren’t dangerous, but they can turn cancerous over time.  

What are survival rates for colon cancer? 

Although survival rates among people with colon cancer have been improving overall, among young people they have actually been getting worse.  

When colon cancer is caught early and before the cancer has a chance to spread to other parts of the body, five-year survival rates are high, between 70% and 90% for all age groups depending on if and where the cancer has spread.  

For cancer that has spread to distant parts of the body, however, five-year survival rates are only 15% — which is why it’s extremely important to go to the doctor if you have any signs, however mild, that could potentially be caused by colon polyps or cancer. 

“Our hope is always that we will be able to see polyps and remove them before they turn into cancer,” Krane says. 

Who is at greater risk for colon cancer? 

People with certain medical conditions, such as inflammatory bowel disease (ulcerative colitis and Crohn’s disease), are at higher risk for developing colon cancer. Certain lifestyle and behavioral factors, such as smoking, heavy alcohol use, a diet high in red meat and fat that’s also low in fiber and fruits and vegetables, and a sedentary lifestyle may increase someone’s risk.

Genetics can also play a role, with some gene mutations contributing to higher risk. If there’s a history of colon cancer or polyps in your family, that’s an important thing to mention to your doctor. 

Colorectal cancer also disproportionately affects some people of color, particularly Alaska Natives, who face the highest rates of colorectal cancer among any racial group, and Black people, who face disproportionately high mortality rates from colorectal cancer. Ashkenazi Jewish people also face higher-than-average risk. 

These are disparities that researchers at UW Medicine are learning about so they can understand how to prevent and mitigate them, Krane says. 

What can help prevent colon cancer? 

Things you can do to help prevent cancer are also things that are just plain healthy and good for your body like exercising, eating a balanced diet and not smoking.  

Knowing your family medical history is also important. If relatives have had colon cancer or a history of colon polyps, it’s important to tell your doctor.  

Getting screened for colon cancer regularly is also important, especially if you’re over age 45 or have risk factors. There are a few types of screening, such as different types of stool tests, but for people with higher risk, Krane recommends a colonoscopy. 

“The gold standard is a colonoscopy. It involves using a camera that allows the doctor to evaluate the entire lining of someone’s colon and rectum. The camera can see small polyps, which is where small cancers come from, and then the doctor can remove and biopsy them,” Krane says. 

The takeaway 

Colon cancer, while traditionally seen as a disease that only affects older people, is still a risk for younger people, particularly people who have irritable bowel disease, colon polyps or a family history of colon cancer. If you have any symptoms that could indicate colon cancer, you should make an appointment with your doctor. 

This article was originally published on October 7, 2020. It has been reviewed and updated with new info.