Rates of early onset colorectal cancer in adults aged 25 to 49 are rising worldwide, according to a new study
Rates of early onset colorectal cancer in adults aged 25 to 49 are rising worldwide, according to a new study
In recent years, there has been a troubling trend: colon cancer is increasingly being diagnosed in individuals under the age of 50. This shift raises critical questions about the underlying causes, prompting us to examine several lifestyle and biological factors that may be contributing to this alarming rise.
1. Alcohol Consumption
Alcohol consumption has long been linked to various health issues, including several types of cancer. Research indicates that excessive drinking can lead to inflammation and damage to the digestive tract, potentially increasing cancer risk. For younger adults, social norms often promote higher alcohol intake, particularly during formative years. This behavior may inadvertently contribute to the increased incidence of colon cancer in this demographic.
2. Obesity
Obesity is a well-established risk factor for many health problems, and its link to colon cancer is becoming increasingly evident. The rising rates of obesity among young adults can be attributed to various factors, including poor dietary choices and a shift towards convenience foods that are often high in unhealthy fats and sugars. Excess body fat, especially in the abdominal area, can lead to changes in hormone levels and inflammation, both of which may contribute to cancer development.
3. Sedentary Lifestyle
The modern lifestyle, characterized by prolonged periods of sitting and reduced physical activity, plays a significant role in overall health and cancer risk. Sedentary behavior is associated with a range of negative health outcomes, including obesity and metabolic syndrome, which are linked to an increased risk of colon cancer. Encouraging a more active lifestyle among young people could be vital in reversing this trend.
4. Changes in the Gut Microbiome
Emerging research highlights the role of the gut microbiome in overall health, including its potential influence on cancer risk. The Western diet, high in processed foods and low in fiber, can disrupt the balance of gut bacteria, leading to dysbiosis. This imbalance may promote inflammation and alter metabolic processes, potentially paving the way for cancer. As young adults increasingly adopt diets that lack diversity and essential nutrients, the implications for gut health—and, by extension, cancer risk—cannot be ignored.
The Role of Screening: Colonoscopy and Polypectomy
In the face of this rising incidence, the importance of early detection cannot be overstated. Colonoscopy serves as a crucial screening tool, allowing gastroenterologists not only to detect colorectal cancer but also to identify and remove precancerous polyps through polypectomy. This proactive approach can significantly reduce the risk of developing cancer, making regular screenings essential, even for younger individuals with risk factors.
Other Screening Tools
While colonoscopy remains the gold standard, a range of other screening tools is available. Non-invasive options, such as stool-based tests, can also play a role in early detection. These methods can help identify abnormalities that warrant further investigation. Encouraging open discussions about screening options and their importance can empower individuals to take charge of their health, emphasizing that prevention is always preferable to treatment.
Conclusion
The rising incidence of colon cancer among those under 50 is a complex issue influenced by multiple interconnected factors, including alcohol consumption, obesity, sedentary lifestyles, and changes in the gut microbiome. Addressing these issues requires a multifaceted approach that includes education, lifestyle modifications, and increased awareness of the importance of early screening. By prioritizing health and well-being, we can work towards reversing this unsettling trend and fostering a healthier future for younger generations. Regular screenings, including colonoscopy and polypectomy, are vital in this fight against colon cancer, enabling us to detect and prevent the disease before it becomes a more significant threat.
Article by Maria Lally
Just before Deborah James was diagnosed with bowel cancer in 2016, the cancer campaigner, who went on to raise millions for charity and was given a damehood by Prince William, was told by her doctors not to worry because she was a 35-year-old vegetarian who had run a marathon. However, that offered little protection and she was diagnosed with stage four bowel cancer. She died six years later aged 40. A new study from the American Cancer Society published this week has found that rates of early onset colorectal cancer (EOCC) in adults aged 25 to 49 are rising worldwide, with England experiencing the fourth fastest increase overall, and the highest in Europe. Michelle Mitchell, the chief executive of Cancer Research UK, has called the findings concerning and says more research is needed “to understand what’s causing this trend in younger people”. Cancer Research UK and the Bowelbabe Fund, which James set up shortly before she died, along with other cancer charities, are now funding Team Prospect to examine the rising rates of bowel cancer in under-50s.  |
One of the UK scientists involved in the research is Sarah Berry, a professor in nutritional sciences at King’s College London. “We’re running a huge project, looking at underlying risk factors and doing deep mechanistic work looking at how these factors impact the development of early onset colorectal cancer,” she says.
Symptoms of bowel cancer include bleeding from your bottom, blood in your poo, a persistent and unexplained change in bowel habits, unexplained weight loss, extreme tiredness for no obvious reason, or a pain or lump in your tummy. Berry says the most well-established risk factors for bowel cancer are family history, obesity, diet and alcohol intake.
“Anyone wanting to reduce their risk needs to think about how they can modify their diet,” she says. “Alcohol intake and in particular binge drinking seems to be a problem, and evidence shows that binge drinking increases your risk of early onset colorectal cancer. Alcohol full stop increases the risk, but while drinking with meals seems to lessen the impact, that doesn’t mean you can drink freely with meals because alcohol still increases your risk.”
As does obesity, so working to maintain a healthy body weight is important, says Berry, who says that every increase in your BMI (body mass index) ups your risk of EOCC. “Diet is important, and red processed meat, sugar-sweetened drinks, highly refined processed carbs, and ultra-processed foods also increase your risk.”
As for what you should eat, Berry says upping your fibre intake is particularly important. “It can modify your gut microbiome [the bacteria that plays a key role in your health] to a healthier composition, which we know plays a key role in the development of colorectal cancer,” she says. “Eat more plant-based foods, such as fruits, vegetables, pulses and wholegrains, and those rich in polyphenols, such as fruits and vegetables, and extra virgin olive oil.
“Inactivity is another risk factor, and there’s evidence that excessive sitting might increase your risk as well as being inactive. So incorporate activity into your day, and get up every now and then to move around. All this will reduce your risk not just of developing early onset colorectal cancer, but most diet-related diseases like cardiovascular disease and type 2 diabetes.”
However, like Deborah James, Dr Anisha Patel was a fit and healthy mother of two when she was diagnosed with bowel cancer at the age of 39, in 2018. Patel, a GP and author of Everything You Hoped You’d Never Need To Know About Bowel Cancer, says: “I’m part of a community of under-50s who don’t have any of the well-known risk factors associated with bowel cancer. That’s why I’m involved in the Prospect study, as their lead patient advocate. Those born in 1990 have twice the risk of colon cancer and four times the risk of rectal cancer compared with those born in 1950.
“Is it microplastics in our environment, or the rise in ultra-processed foods? We’re also seeing more bowel cancer across the world and in developing countries like India. Something is causing more inflammation, which is causing cell changes. And we need to know what it is.
“If you survive bowel cancer, you can be left with bowel dysfunction, you can lose your fertility, treatment can bring on early menopause, as well as the mental health impact. All this in a working-age population has a massive impact.
“In medical school, I was taught that bowel cancer was a disease of older men who smoked, drank and ate lots of red meat, but I couldn’t be further from that profile. Bowel cancer doesn’t discriminate, so if you have any of the symptoms, see your GP, and don’t be embarrassed to talk to them about your poo. We need to shine a light on early onset bowel cancer.”