There has been a sharp rise in colorectal cancers in adults as young as in their 20s and 30s in the U.S., found a new study from the American Cancer Society (ACS).
The vast majority of colorectal cancers are still found in older people, with nearly 90 percent of all cases diagnosed in people over 50, colorectal cancer rates, which had dropped steadily for people born between 1890 and 1950, have been increasing for every generation born since 1950, said the study published on Tuesday.
“Age-specific colorectal cancers risk has escalated back to the level of those born circa 1890 for contemporary birth cohorts, underscoring the need for increased awareness among clinicians and the general public, as well as etiologic research to elucidate causes for the trend,” concluded the study.
“Further, as nearly one-third of rectal cancer patients are younger than age 55 years, screening initiation before age 50 years should be considered,” it said.
The study, based on the analysis of the incidence patterns of colorectal cancer in the country from 1974-2013, found that in adults ages 20 to 39, colon cancer rates have increased by 1 percent to 2.4 percent a year since the mid 1980s, while rates declined overall among those 55 and older. Rates among adults 40 to 54 increased by 0.5 percent to 1.3 percent a year since the mid-1990s.
Colorectal cancer (CRC), also known as bowel cancer, is the development of cancer from the colon or rectum (parts of the large intestine). A cancer is the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Signs and symptoms may include blood in the stool, a change in bowel movements, weight loss, and feeling tired all the time.
Most colorectal cancers are due to old age and lifestyle factors with only a small number of cases due to underlying genetic disorders. Some risk factors include diet, obesity, smoking, and lack of physical activity. Dietary factors that increase the risk include red and processed meat as well as alcohol. Another risk factor is inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis. Some of the inherited genetic disorders that can cause colorectal cancer include familial adenomatous polyposis and hereditary non-polyposis colon cancer; however, these represent less than 5% of cases. It typically starts as a benign tumor, often in the form of a polyp, which over time becomes cancerous.
Bowel cancer may be diagnosed by obtaining a sample of the colon during a sigmoidoscopy or colonoscopy. This is then followed by medical imaging to determine if the disease has spread. Screening is effective for preventing and decreasing deaths from colorectal cancer. Screening is recommended starting from the age of 50 to 75. During colonoscopy, small polyps may be removed if found. If a large polyp or tumor is found, a biopsy may be performed to check if it is cancerous. Aspirin and other non-steroidal anti-inflammatory drugs decrease the risk. Their general use is not recommended for this purpose, however, due to side effects.
Treatments used for colorectal cancer may include some combination of surgery, radiation therapy, chemotherapy and targeted therapy. Cancers that are confined within the wall of the colon may be curable with surgery while cancer that has spread widely are usually not curable, with management being directed towards improving quality of life and symptoms. Five year survival rates in the United States are around 65%. This, however, depends on how advanced the cancer is, whether or not all the cancer can be removed with surgery, and the person’s overall health. Globally, colorectal cancer is the third most common type of cancer making up about 10% of all cases. In 2012, there were 1.4 million new cases and 694,000 deaths from the disease. It is more common in developed countries, where more than 65% of cases are found. It is less common in women than men.
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