Colorectal Cancer in the Young

By Sandra Samuels, MD

Colorectal cancer is trending downward in populations above 50 years of age, in part due to screening colonoscopy, which is recommended at age 50 years and above. However, it has recently been increasing in younger adults ages 20-49. The reason for this trend remains a mystery. CRC in the young is aggressive, and often is detected after it has metastasized often because of delayed detection.

It has been known for a long time that young adults with chronic bowel diseases such as Crohn’s, ulcerative colitis, or hereditary conditions such as Familial Polyposis, or Lynch syndrome, have a higher incidence of colon cancer, and these patients have always been followed closely.

Warning signs include rectal bleeding, dark stools, pallor, abdominal mass or unexplained weight loss. Non-specific symptoms include changes in bowel habits or stool characteristics, abdominal pain, and general fatigue.

Everyone can lower their risk of colorectal cancer by eating diets plentiful in fresh fruit and vegetables, and whole grains, reducing processed meats and red meat, exercising regularly, maintaining optimal weight, limiting alcohol ingestion, and NOT smoking.