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Our editorial team digs deep to present you with facts that matter, providing a unique perspective on the issues shaping our world. Meanwhile, our designers format it for you into a beautifully curated layout. We hope you enjoy it. | | Colorectal Cancer Is Striking Young People, and 'Some New Exposures' May Be Fueling It | From 2000 to 2020, the incidence rate of colorectal cancer decreased by nearly half. However, among people younger than 50, the rate rose. | (Illustration by The Epoch Times, Shutterstock) | By Flora Zhao | April 06, 2024 Updated: April 11, 2024 Overall, colorectal cancer incidence has been decreasing. But surprisingly, the incidence rate among young people is on the rise. "Some new exposure" that emerged in the mid-20th century could be causing it, Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society, told The Epoch Times. According to data from the American Cancer Society, from 2000 to 2020, the incidence rate of colorectal cancer decreased by nearly half. However, among people younger than 50, the rate rose to more than eight per 100,000 people from six per 100,000 people. | From 2000 to 2020, the incidence rate of colorectal cancer decreased, but among people under 50, the rate rose. (The Epoch Times) | Colorectal cancer diagnosed before the age of 50 is known as early-onset colorectal cancer. Over the past two to three decades, the incidence of early-onset colorectal cancer has increased at a rate of 1 percent to 2 percent per year, while mortality rates have also increased by 1 percent per year, according to a 2024 American Cancer Society report. Today, colorectal cancer is the leading cause of cancer death in men younger than 50, and it ranks second only to breast cancer in women younger than 50. More Advanced Cancer Abnormal cells in the gut lining can grow into polyps, and some polyps may become cancer after 10 to 15 years. Subsequently, they can metastasize to nearby lymph nodes or other parts of the body. | How colorectal cancer develops from polyps. (Illustration by The Epoch Times) | The large intestine is the final part of the digestive system—the first five feet are called the colon, and the last six inches are the rectum, which connects to the anus. Colon cancer and rectal cancer are often grouped because they share many common features and are collectively referred to as colorectal cancer. Early-onset colorectal cancer is "a little bit different" from other colorectal cancers, according to Dr. Jeremy Kortmansky, associate professor of medical oncology at the Yale School of Medicine and clinical director of the Division of GI Medical Oncology at the Yale Cancer Center. It is more likely to occur in the lowest part of the colon and the rectum. Patients tend to present symptoms such as rectal bleeding and changes in bowel habits. Dr. Kortmansky noted that upon microscopic examination, tumor cells in early-onset colorectal cancer patients "tend to have more aggressive histology," a characteristic that seems to be somewhat related to the cancer being diagnosed at an advanced stage. Among patients diagnosed with colorectal cancer between the ages of 20 and 49, there is a larger and faster-growing proportion of patients with cancer that has already metastasized compared to older adults. Forty-seven percent have cancer that has spread locally at the time of diagnosis, while 27 percent have distant metastases. Many young people are misdiagnosed or have their symptoms overlooked. "Doctors are not thinking about cancer in people in their 20s and 30s," Ms. Siegel said. By the time they are diagnosed, it is often in the late stages. A statistical study published in 2019 found that among early-onset colorectal cancer patients with rectal bleeding symptoms, the average time from the symptoms to diagnosis was 271 days. By then, nearly half of the patients' cancer had already metastasized. Both genetics and obesity may be factors contributing to the alarming early-onset cancer trend. A large prospective study of more than 85,000 women published in JAMA Oncology shows that being overweight increases the risk of early-onset colorectal cancer by 37 percent, while obesity increases the risk by 93 percent, almost doubling it. Dr. Kortmansky explained that obesity alters hormone levels, such as adiponectin and leptin, which can promote tumor growth. This, in turn, triggers the early onset of other cancers, such as breast, pancreatic, and endometrial cancers. "But excess body weight accounts for only about 5 percent of all colorectal cancers," Ms. Siegel said. "Probably it's not obesity that is solely driving the increase." She cited African Americans as an example; despite experiencing the largest increase in body weight compared to other populations, they have seen the smallest increase in the rate of colorectal cancer incidence. The situation is more complex than that. The Post-1950s Era "While there are many known risk factors for colorectal cancer in general, these are based on older generations," Ms. Siegel said, pointing out that there is a strong birth cohort effect in early-onset colorectal cancer among those born after the 1950s. The more recent a person's birth, the higher the risk, she said, noting that this indicates that "some new exposure is causing that higher cancer risk." Specifically, the incidence of late-onset colorectal cancer in the United States began to rise in the 1950s. In comparison, the incidence of early-onset colorectal cancer did not start to increase until the 1990s. A 2022 study published in the Journal of Clinical Oncology by scientists from several authoritative cancer research institutions highlighted that new risk factors for colorectal cancer emerged during that period. Older individuals might have already accumulated detrimental cellular alterations, which, coupled with the dietary and lifestyle changes of that era, led to a rapid increase in the incidence of colorectal cancer. However, for those born during that period, such early-life exposures to risk factors require a relatively long time (several decades) to lead to an increase in cancer incidence. "There are so many changes in our lifestyle," Ms. Siegel said. "Food supply's very different; much more processed food. People's lifestyle is much more sedentary." | Subscribe to The Epoch Times to read the rest. Become a paying subscriber of The Epoch Times to get access to
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