"The number of patients under the age of 50 who have been diagnosed with colorectal cancer has been climbing, and we don't have any identified reason as to why," says Joseph DiRocco, M.D., MBA, FACS DiRocco is the director of gastrointestinal oncology for the Sandra & Malcolm Berman Cancer Institute at GBMC.
March is Colon Cancer Awareness Month, and here are three things to consider when assessing your risk for the disease.
Follow screening guidelinesExcluding skin cancers, colorectal cancer is the third most common cancer diagnosis in the United States. According to the American Cancer Society (ACS), the overall rate of colorectal cancer has been dropping steadily for several decades. However, the rate of diagnosis for people under the age of 50 has been increasing up to 2% every year without an exact cause. As a response to this increase, the ACS recently updated their screening guidelines to recommend that testing for adults at average risk should begin at age 45, five years younger than the previous recommendation.
"If you have a first-degree relative with colon cancer, especially if they were diagnosed before the age of 65, those people should start screening at age 40, or 10 years before the youngest relative was diagnosed with cancer," DiRocco recommends. "You should be screened once every 10 years if you're someone with no risks factors or symptoms. If you have a history of polyps (abnormal growths) or a family history, screening should happen more often."
The most effective form of screening is a colonoscopy, says Dr. DiRocco.
"There is a new screening test out there, called Cologuard, but it's not as sensitive as a colonoscopy and there's a risk of false results. The likelihood of missing cancer on a colonoscopy is quite low," he explains.
A colonoscopy will detect cancerous tumors and polyps (small tissue growth) that have the potential to turn into cancer, so they can be removed before they become too serious.
Be aware of the signs and symptoms of colon cancerColorectal cancer has a high survival rate if caught and treated early. Dr. DiRocco says the problem is that the symptoms of colorectal cancer can often be mistaken for something less serious or discounted if the person is under the age of 50. He says colon cancer isn't on most people's radar when they're young.
"Rectal bleeding is typically more common with rectal cancers, but it can occur in colon cancer cases. Any new abdominal pain that's otherwise unexplained and any change in bowel habits are common early symptoms. There are also more generalized symptoms like unexplained weight loss, decreased appetite and fatigue," says Dr. DiRocco. He adds that it's important to not dismiss anything out of the ordinary and stresses that if anything feels off, you should see your doctor right away.
Minimize general risk factorsWhile the rise in colorectal cancer diagnoses in the younger population can't be blamed on one singular factor, there are some things you can do to lower your risk of getting the disease.
1. Pay attention to your diet."Diet is a big issue when it comes to the intestinal tract, and people like to focus on that," Dr. DiRocco says. "There is some evidence that processed meat can increase your risk of developing colon cancer. Regular alcohol consumption can increase your risk."
The ACS says a diet high in fiber and whole foods like fruit and vegetables can minimize this risk.
2. Keep a healthy lifestyle.This includes maintaining a healthy weight and not smoking or drinking in excess. The ACS recommends no more than two drinks per day for men and one for women. Obesity and excess body fat have been shown to be associated with an increased risk of colorectal cancer. People with Type 2 diabetes also have an increased risk of colorectal cancer.
3. Be aware of your family historyDr. DiRocco says a genetic history of colorectal cancer should make you more aware to changes in your overall health, but it's not the defining factor of a colon cancer diagnosis.
"People with a family history make up 25% of the diagnoses in the U.S.," he explains. "But more than 50% of those diagnosed have no risk factors or family history or anything like that."
The key takeaway Dr. DiRocco wants everyone to realize is how serious colon cancer is, and that it can affect anyone.
"150,000 people are diagnosed every year and 50,000 people die. You can't just rely on good genes and a good diet."
He reiterates that the best way to protect yourself is to get a colonoscopy.
"This painless procedure that's very safe, compared to major surgery once a problem is already there, is an easy trade-off. I'm 45 and have had two."