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Colon cancer and young adults

Study shows colorectal cancer is on the rise in 20- to 49-year-olds


Dr. Jonathan Lamphier of Novant Health Gastroenterology Brunswick will never forget one of his young patients who was referred to him after experiencing rectal bleeding.

She was a college senior at the time.

“She didn’t have any family members with colon cancer or polyps, and there were no other cancers in the family,” Lamphier said. “Colon cancer isn’t the highest likely candidate on the list when a young person experiences rectal bleeding, but it still has to be considered. In the past, gastroenterologists may have treated cases like this a bit more cavalierly and assumed the issue was hemorrhoids, given her age.”

Her colonoscopy revealed a different story. “Her colon was, essentially, wall-to-wall polyps,” Lamphier said. “There were so many you couldn’t count them or remove them. Testing the bigger and more irregular ones showed she had colon cancer that was already widely metastatic. She survived for about a year and a half.”

Report finds colorectal cancer on the rise in the young

Nearly 137,000 people will be diagnosed with colorectal cancer in the U.S. this year, and more than 50,000 will die of the disease.

Colorectal cancer was once thought to only affect those over age 50. But the cancer is cropping up in younger patient populations at such a rate that researchers at the University of Texas MD Anderson Cancer Center say that in the next 15 years, 1 in 10 colon cancers and nearly 1 in 4 rectal cancers will be diagnosed in patients younger than 50.

The report finds that the overall incidence of colorectal cancer has been on the decline since 1998, with a marked decrease in patients 50 years old and older. Conversely, colorectal cancer rates have increased for patients ages 20-34.

Based on current trends, the report predicts that by 2030, the incidence of colon and rectal cancer will increase by 90 percent and 124.2 percent, respectively, for patients ages 20-34. For patients ages 35-49, those cases are expected to increase by 27.7 percent and 46 percent, respectively.

The cause for the spike in younger populations is, as of now, unknown.

“The patient I spoke of had genetic testing done,” Lamphier said. “It all came back normal. Her family members have all had normal colonoscopies. Some genetic cancers are measurable; others we haven’t been able to identify the specific mutation, but it stands to reason there is a genetic link to the early onset cases that we haven’t been able to nail down yet.”

He admitted he’s been surprised at the number of young people he’s seen over the past few years who have precancerous colon polyps without any risk factors for the disease. “It’s something gastroenterologists really have their sights on right now,” he said.

What to look for and why that colonoscopy is so important

Lamphier advised that no one, of any age, should ignore rectal bleeding. “People who bleed from their bottoms have a higher risk of having some serious abnormality,” he said. “Most patients will have a benign cause of bleeding, such as hemorrhoids or fissures. But it’s important to treat every case as suspect.”

He underscored that seeking medical attention early gives you a better chance of finding and removing a polyp before it ever turns into cancer.

“Colonoscopy is not the big, bad procedure most people think it is,” Lamphier said. “The sedation is thorough and efficient and patients don’t feel any discomfort. Plus, the prep is so much better than years ago when we used to basically give patients a gallon of saltwater to drink. Today, we have smaller volume preps and tasteless laxatives that can be mixed with other drinks so it’s palatable and effective.”

He added, “Most communities have skilled gastroenterologists, and most insurance companies cover the procedure. It’s a good time to address these things before they become big problems. Don’t ignore getting a colonoscopy.”





Published: 3/5/2015