English
March is National Colorectal Cancer Awareness Month.
Colon cancer was once considered rare in young people, but now one in five diagnoses of the disease occurs in people under 55. These diagnoses, called “early-onset colorectal cancer” or “early-onset colorectal cancer,” refer to colorectal cancers found in people under 50 years of age.
Rates are rising so quickly that colonoscopies are now recommended at age 45, five years earlier than before.
We have with Dr. Laura Van Meter Baum, a medical oncologist at the Dana-Farber Cancer Institute, spoke to learn more about this worrying trend.
Do we know why the number of colon cancer diagnoses in young people is increasing?
Since the 1950s, we have noticed that the number of early-stage colon cancers is increasing worldwide. We have identified some risk factors, but these factors do not fully explain this increase. There are likely several factors, including lifestyle and dietary habits, as well as environmental and other factors, that can affect your health. Because we know that lifestyle and dietary patterns play a role in increasing your risk, it is important to remember that these are risks that we can control. A diet rich in processed and highly processed foods and low in fiber, obesity, a sedentary lifestyle, smoking and alcohol consumption are factors that lead to all kinds of health problems, including colon cancer.
Are there differences in symptoms and survival rates between early-onset colorectal cancers and those that occur in older people?
There are not necessarily other cancer symptoms, but younger people are less likely to be tested for colorectal cancer, so they are more likely to have symptoms if they are diagnosed. Symptoms such as abdominal pain, weight loss, iron deficiency anemia or changes in bowel movements can be signs of colon cancer. In addition, younger people are more likely to develop cancer in the rectum or the left side of the colon. Consequently, there is also a higher chance of bright red blood mixing in the stool, which is more common in left-sided and rectal tumors.
As for survival rates, this is surprisingly controversial. Patients with early-stage colorectal cancer are more likely to have the cancer at a more advanced stage, so they have a lower mortality rate. About 7 in 10 young people receive the diagnosis at a late stage, compared to 6 in 10 people who receive the diagnosis after age 50. Looking specifically at each stage, some recent studies suggest that younger people’s survival rates are better than those diagnosed at an older age because they receive more intensive therapies. However, other studies show no difference or even worse survival rates. However, we have seen that very young patients, for example people under 30 or 35 years of age, generally have worse clinical outcomes.
Are certain mutations more common in early-stage colon cancer?
While 10% of colorectal cancers diagnosed after age 50 are the result of inherited genetic mutations (also known as “germline mutations”), we have seen that genes play a larger role in early-onset colorectal cancer. Approximately 15 to 30% of early-onset colorectal cancers are associated with inherited genetic mutations that cause familial cancer syndromes. Lynch syndrome is the most common of these disorders, but there are other genetic syndromes that contribute to this risk. We are also identifying more new mutations in tumors from people with early-stage colorectal cancer. These mutations, called “somatic mutations,” are mutations in the tumor itself and not in the patient’s genes. In general, patients with early-stage cancer have different types of mutations compared to older patients, which may impact their clinical outcomes.
Watch: Understanding Lynch Syndrome: What Women Should Know >>
What types of treatment are most commonly used for early-onset colorectal cancer?
Treatment usually includes a combination of surgery, chemotherapy and radiation. Another treatment option is immunotherapy, which fights cancer by specifically targeting genetic mutations if applicable depending on the diagnosis.
I said earlier that people who receive this diagnosis when they are younger tend to receive more aggressive treatment, but that doesn’t always happen. It also depends on the cancer, where it is located and how aggressive it is. Another factor is how well the patient tolerates the treatment.
Is there a difference in treatment between a 45 year old and a 68 year old if they are healthy other than this disorder?
No. However, if the patient suffers from other illnesses or cannot tolerate certain therapies, we adapt the treatment to their needs. In general, the younger the patient, the more likely it is that they will tolerate and receive a broader range of treatments.
Can younger people do something to prevent colon cancer?
A healthy lifestyle is helpful, but it’s important to remember that we can’t really control whether or not we have cancer. We have seen many young patients who are triathletes and are doing everything right. I recommend eating a healthy diet rich in fiber, exercising, quitting smoking and consuming less alcohol. I think awareness is useful too.
It’s important to know that colon cancer doesn’t just affect people over 50. Younger people should talk to their doctor if they have possible symptoms or changes in their bowel movements.
A very important point: When it comes to colon cancer, screening examinations are actually preventative tools. During a colonoscopy, the doctor not only tries to detect cancer, but can also detect and remove polyps before they become cancerous.
Read: Your test guide for colon cancer detection >>
Are there additional considerations regarding treatment side effects and clinical outcomes in young adults with colorectal cancer?
Colorectal cancer is different in younger people, especially because they are at different stages of life before age 50. If the patient wishes to become pregnant, fertility issues may need to be considered in treatment, particularly if she requires radiation therapy. Receiving cancer treatment with young children can place greater stress on family life.
Relationship problems can be different for younger people. For example, if you need a permanent ostomy bag, you may have a lot of emotions about dating someone or starting a romantic relationship or marriage. Cancer disrupts academic and professional life and can have a significant financial impact. Dealing with colon cancer at a young age can be a real setback: emotionally, physically and financially. Of course we try to help people and provide support.
In addition, treatment improves. Colon cancer is not easy, but the earlier it is diagnosed, the more options and chances of recovery you have.
This educational resource was created with support from Merck and Takeda.
From your website articles
Related articles on the Internet
