Recent years have seen a concerning uptick in gastrointestinal cancers, including colorectal cancer, among individuals under the age of 50. While cancer is predominantly associated with aging, younger demographics are experiencing a notable surge in digestive system malignancies. This shift has prompted discussions on the potential drivers behind this trend.
According to experts, factors such as obesity, Western dietary patterns, nonalcoholic fatty liver disease, smoking, excessive alcohol consumption, and exposure to microplastics may play a role in the rising incidence of early-onset colorectal cancer. Additionally, a study published in Nature Medicine has projected a significant increase in gastric cancer cases, primarily linked to Helicobacter pylori infection, if preventive measures are not implemented promptly.
The exact causes of this surge in gastrointestinal cancers are not yet fully understood. However, research suggests that environmental influences, lifestyle choices, and diet could be contributing factors. Notably, a study published in The British Journal of Surgery indicates a 14.8% rise in early-onset colorectal cancer cases in the United States between 2010 and 2019, mirroring a global trend of increasing rates.
Anton Bilchik, MD, PhD, a surgical oncologist and expert in gastrointestinal cancers, highlights the potential impact of various factors such as diet, exercise habits, and stress on the development of early-onset malignancies. The complex interplay between these factors and the body’s microbiome and immune system may contribute to a proinflammatory environment conducive to cancer growth.
Of particular concern are the substantial increases observed in colon and rectal cancers among younger generations. Data shows that individuals born in 1990 are significantly more likely to develop these cancers compared to those born in 1950. In European countries, colorectal cancer rates have risen across age groups, with notable spikes in younger populations.
In light of these findings, there is a growing need for research and public health initiatives to better understand and address the factors driving the rise of gastrointestinal cancers in younger individuals.
According to data from the Centers for Disease Control and Prevention (CDC) Wonder database in the U.S., there has been a significant increase in the incidence of colorectal cancers among young adults. The study identified a 333% increase in cases among 15-19 year olds and a 185% increase among those aged 20-24. Although these percentage increases are substantial, the absolute number of cancer diagnoses in individuals under 50 remains lower than in older age groups.
Researchers stress the importance of targeted awareness and interventions, especially among younger populations. Dr. Bilchik echoed this sentiment, emphasizing the need for public awareness of gastrointestinal (GI) cancer as the leading cause of cancer-related deaths in males under 50 and the second leading cause in women. The US Preventative Task Force has lowered the screening age to 45, and there are discussions about potentially reducing it further to 40 due to the disproportionate rise in cases among Black and Hispanic individuals compared to non-Hispanic whites.
Factors contributing to the increase in early-onset colorectal cancer include obesity, excessive alcohol consumption, a Western-style diet, lack of physical activity, and consumption of sugary beverages. Other factors like exposure to microplastics and changes in the gut microbiome have also been implicated. However, not all patients with early-onset colorectal cancer exhibit these risk factors, highlighting the need for ongoing research to better understand these trends.
A separate study by researchers at the International Agency for Research on Cancer of the World Health Organization found a link between gastric cancers and infections with the bacterium Helicobacter pylori. The study estimated that a significant number of gastric cancer cases could be prevented by addressing these infections through education and preventive strategies.
While the reasons for the rise in colorectal cancer cases remain unclear, experts recommend focusing on early detection for more effective treatment. Dr. Nilesh Vora, a hematologist and oncologist, also suggests the importance of early detection in reducing colorectal cancer cases in older individuals.
The expert highlighted the importance of colonoscopies for screening to detect precancerous lesions and reduce the risk of colon cancer. The recommended screening age has been lowered to 45, and there is potential for even younger patients to benefit from screening. It is crucial for asymptomatic individuals to follow screening guidelines, while those with symptoms should consult a doctor. In the United States, individuals at average risk should start screening at age 45, with earlier screening recommended for those with a family history of colorectal cancer. Younger adults should discuss familial risk with their families. Ongoing research aims to customize screening programs for younger individuals at higher risk for early-onset colorectal cancer. Lifestyle changes such as avoiding smoking, excessive alcohol, and red meat, addressing vitamin D deficiency, and staying physically active can help reduce the risk of colorectal cancer.
