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What to Know About Young Adults & Colorectal Cancer

March 16, 2021

In 2021, nearly 150,000 new cases of colorectal cancer are expected to be diagnosed among Americans, according to the American Cancer Society. And while many of those cases will be diagnosed in seniors, a rising number will impact young adults.

In the past, colorectal cancer was largely thought to affect only older adults. That’s why colorectal cancer screenings were previously recommended to begin at age 50.


Jeff Kovalic, MD

But the past couple decades have shown that this common type of cancer also affects younger adults. The death of Black Panther star Chadwick Boseman last August at age 43 shined a light on colorectal cancer and its impact on people of younger ages.

His death is indicative of a rising problem. Read on as Jeffrey Kovalic, MD, radiation oncologist with the Kirkland Cancer Center, shares some thoughts about the increase of colorectal cancer among younger people.

What We Know About Colorectal Cancer
Colorectal cancer is a type of cancer that originates in either the colon or the rectum. While colon cancer and rectal cancer are also referenced separately, they’re often grouped together.

Most cases of colorectal cancer begin as what’s called a “polyp,” which is a growth that turns into cancer over a period of time. These growths appear on the inner lining of either the colon or the rectum.

Because precancerous polyps can take years to develop into cancer, colorectal cancer can often be prevented by removing the polyps during a routine screening known as a colonoscopy. 

If not removed, though, polyps can spread along the wall of the colon or rectum over time. Eventually, the cancer can also spread into nearby or even distant lymph nodes or tissue.

Why Colorectal Cancer Is Affecting Young Adults
Previous recommendations have called for those of average risk to have a first colonoscopy at age 50, repeated every 10 years thereafter.

While this strategy for screening is incredibly effective in finding—and removing—precancerous polyps in older adults, the later start to screening means polyps in younger adults often develop into cancer before they’re detected.

But why is colorectal cancer occurring in young adults in the first place? Well, researchers aren’t entirely sure. 

What is clear, though, is that there’s a sharp increase in cases in young adults. Since the 1990s, the rate of colorectal cancer has doubled in adults younger than age 50. Not only is this population increasingly getting the disease, but they’re also more likely to die from the disease.

Researchers believe that the increase in colorectal cancer may be driven at least in part by our lifestyle habits. Compared with the habits of Americans even two decades ago, Americans today are less likely to exercise consistently, more likely to eat a diet high in saturated fat and sodium and more likely to be overweight or obese.

Diet may play a particularly important role in increased colorectal cancer risk. Today, we’re much more likely to eat diets low in fiber and high in animal protein, both of which increase the risk of colon and rectal cancer.

What You Can Do to Lower Colorectal Cancer Risk
Because those younger than age 50 represent an increasing portion of colorectal cancer diagnoses, screening guidelines have been adjusted in recent years, advocating beginning average risk colorectal screening at the age of 45.  The majority of colorectal cancer however, occurs in patients over the age of 50 and the benefits of screening early must be carefully weighed against the potential harms. These risks and benefits should be discussed with your provider before any screening.

But since screening doesn’t typically begin until age 45, what else can you do to decrease your risk of colorectal cancer? It starts with healthy lifestyle habits:

  • Aim to exercise for at least 150 minutes each week, or around 30 minutes per day.
  • Eat a diet filled with fiber and low in saturated fat, sodium and added sugar.
  • Limit your intake of processed and red meats.
  • Don’t smoke or use tobacco.
  • Get to and maintain a healthy weight, as advised by your PCP.
  • Limit your intake of alcohol.

It’s also important to keep an eye on your digestive health and report any oddities to your provider. In particular, watch for abdominal pain, blood in your stool, constipation, diarrhea, a decreased appetite or unexpected weight loss, which can be signs of colorectal cancer.

Regular checkups and screenings are an important tool for cancer prevention and early detection.  Make an Appointment