WHAT’S BEHIND THE INCREASE IN COLORECTAL CANCER CASES IN YOUNG ADULTS?

Statistics rarely tell the whole story on any topic. Case in point: colorectal cancer. The numbers tell us that the disease is the fourth-most common cancer diagnosed in the United States and the second leading cause of cancer deaths. They also tell us that the rates of new cases and deaths from colorectal cancer have fallen dramatically over the past four decades.

But these numbers only tell part of the story. While overall cases and deaths have declined, especially among older adults, colorectal cancer diagnoses have increased dramatically among young adults.

One statistic that hasn’t changed: Colorectal cancer mostly affects seniors. Sixtysix percent of cases are diagnosed in patients 65 and older. For a variety of reasons—more people are getting screened and fewer people smoking, colorectal cancer rates have declined. Consider that from 1985 to 2018:

• New cases of colorectal cancer declined from 65 to 35 per 100,000 Americans.

• Deaths from the disease have dropped by half, from 26 to 13 per 100,000.

• The five-year survival rate increased from 58 percent to about 65 percent.

But, for younger Americans, the numbers tell a different story:

From 2012 to 2016, new cases of colorectal cancer have increased 2.2 percent a year for Americans younger than 50. The disease has become the leading cause of cancer deaths for Americans 20 to 49 years old, according to the National Cancer Institute. The average age of a patient diagnosed with colorectal cancer fell from 72 in 2001-02 to 66 in 2015-16.

And while African Americans are still more likely than whites to be diagnosed with colorectal cancer, early-onset disease is affecting more non-Hispanic white Americans than African Americans.

Research into the causes of early-onset colorectal cancer is robust. And while a specific cause of the concerning trend has not been pinpointed, Toufic Kachaamy, MD, Interventional Program Specialist at City of

Hope Phoenix, says the causes are clear to him.

“It’s lifestyle,” he says. “There’s no doubt in my mind.” Dr. Kachaamy points specifically to the modern American fast-food diet. For instance, he says, one fast food chain’s French fries contain 16 more ingredients than the potatoes, oil and salt in those you make at home.

“When did our diet become really horrible?” he asks. “It’s when our diet became industrialized. We don’t cook at home. If you make fries at home, it may not be all that healthy, but it’s still better. Nineteen ingredients—that’s not natural.”

Research suggests that a diet that includes frequent fast-food meals may affect the colon’s balance of good and bad bacteria, called the microbiome, microbiota or gut flora. Human microbiota is made of trillions of viruses, fungi and other microorganisms. Imbalances in human gut flora have been linked to autoimmune diseases such as Crohn’s disease, as well as multiple sclerosis and heart disease. While the microbiome’s role in cancer risk remains uncertain, researchers suspect poor gut bacteria may contribute to obesity, a leading risk factor for colorectal cancer. Other risk factors for colorectal cancer include:

• Smoking

• Alcohol consumption

• Sedentary lifestyle

Some cases of colorectal cancer in young adults may also be linked to genetics, or an inherited gene mutation that may increase their risk of developing colorectal or other cancers. In fact, researchers estimate that 15 percent to 30 percent of all colorectal cancer cases in young adults may have this genetic link.

Despite the increase in colorectal cancer rates among young adults, the disease is often overlooked in young patients. Symptoms, such as abdominal pain or blood in the stool, may be attributed to other causes, such as digestive issues or hemorrhoids.

“Also, these folks don’t get screened because they’re so young,” Dr. Kachaamy says. “So, they often come in with advanced-stage disease.”

Prompted by the increase in colorectal cancer cases among younger people, the American Cancer Society now recommends adults at average or low risk get screened for the disease at the age of 45, instead of 50, the previous recommendation.

Dr. Kachaamy’s own lifestyle may serve as a model for those who want to reduce their cancer risk. His family eats meals cooked at home. He exercises six days a week. And he watches little or no television, avoiding the sedentary living afflicting many Americans. “That’s the lifestyle that should be taught,” he says. “But many people don’t have the time for that. It’s just a matter of making it a priority, which I know is hard.”

To reduce your risk of colorectal cancer at any age:

• Exercise: Even a modest amount of exercise every week, such as regular brisk walks, may help improve your overall wellness. Always check with your doctor before starting a new exercise program.

• Eat healthy: A diet high in fiber, lean protein, fruits and vegetables may help promote healthy gut bacteria, which has been shown to reduce cancer risk. Eating too much red meat and processed foods may increase your cancer risk.

• Maintain a healthy weight: Obesity leads to about 500,000 cases of cancer worldwide, according to a recent study. It’s also a known risk factor for many cancers, including those of the colon, rectum, breast and pancreas.

• Don’t smoke: Smoking not only increases the risk of pulmonary cancers, the carcinogens in tobacco smoke travel through the bloodstream and may increase the risk of digestive tract cancers, as well.

FOR MORE INFORMATION VISIT CANCERCENTER.COM. CALL 602.883.1463 TODAY TO SCHEDULE A SCREENING.