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Colon Cancer: What you need to know

10/01/2020

It may not be any surprise to know that colorectal cancer is the third leading cause in cancer related deaths in both men and women in the US. However, actor Chadwick Boseman’s untimely death this August – at just 43 years old - is sparking a new conversation about the rise in colorectal cancer cases in young people. 

Colorectal cancer, which causes tumors to grow in the colon and rectum, is most commonly diagnosed in adults over the age of 50. According to the American Cancer Society (ACS), the lifetime risk of developing colorectal cancer is only about 4%. Even so, since symptoms sometimes don’t present until the disease has advanced, it is a leading cause of cancer deaths in the United States.

What’s promising is that the rate of diagnosis has actually dropped overall since the mid-1980’s, mostly due to updated screening guidelines and people addressing important risk factors related to their lifestyle. Nevertheless, this trend has been seen only in older adults. While the rates in this patient population are decreasing, cases in younger adults are on the rise, and researchers are puzzled as to why.

Steps to take towards colon cancer detection

 “We still wouldn’t deem colorectal cancer a common cancer in patients under 40,” states Dr. Jacob Elkon, an oncologist at Tufts Medical Center. “Since early detection is key with this disease, one of the most important things we like to stress, to younger patients especially, is to make sure they have a designated primary care physician (PCP). We find that many patients in their 20’s and 30’s aren’t seeing one regularly, and it’s important that they do to discuss any symptoms – even if they don’t seem alarming – and any family history of cancer.” 

Dr. Elkon also notes that the idea of screening, specifically colonoscopies, can be considered quite invasive and uncomfortable. However, there are other less invasive options that may be available to lower risk individuals. 

“With regard to existing guidelines, some – those recommended by the American Cancer Society for instance – recommend that people who are at average risk for colorectal cancer begin screenings at age 45,” says Dr. Rob Yacavone, Chief of Gastroenterology at Tufts Medical Center. “People who are at increased risk, however, should definitely get screened earlier.”

Risk factors

Those with a personal or family history of cancer, colorectal polyps, or other gastrointestinal or liver diseases (i.e. IBD or PSC) should consider an earlier or more frequent screening. Racial disparities also play a role in increased risk. According to the ACS, African-Americans have the higher rates of colorectal cancer of any racial or ethnic group in the United States.

Even if you are not high risk for colorectal cancer, one of the most important things that experts suggest is to stay vigilant and don’t dismiss any persistent symptoms, as they can many times mimic those found in benign GI conditions. Important symptoms to be aware of include changes in bowel habits, blood in the stool, narrow stools, abdominal bloating/cramping, and unexplained weight loss.  It’s important – especially for young people – to be aware of these symptoms and discuss them with your health care provider especially if they last longer than a few days. 

“Patients know their own bodies, so they are the best advocates for themselves,” says Dr. Elkon. “Even if a change seems subtle or non-concerning, it’s best to bring it up to your PCP.”

For more information about screening, or to speak with a member of the GI team at Tufts Medical Center, visit tuftsmedicalcenter.org/Gastroenterology.