Colorectal cancers have increased up to six-fold in some groups of young people since 2000, research shows.
Doctors say the cancers are likely going undetected because in the United States, routine screening tests are only recommended every ten years starting at age 45.
The average age of colon cancer patients has gotten younger in recent decades in a trend linked to junk food, obesity and toxic chemicals.
Now, a new analysis has broken down the increase in the most granular detail yet using data from the CDC.
In 2020, only 0.6 children ages 10 to 14 per 100,000 residents were diagnosed with colorectal cancer compared to 0.1 per 100,000 in 1999, an increase of 500 percent. Increases were also seen in older adults, with rates rising 71 percent to 6.5 per 100,000 people ages 30 to 34 and 58 percent to 11.7 per 100,000 ages 35 to 39 in 2020.
Researchers at the University of Missouri-Kansas City found that the rate of colorectal cancer increased by 500 percent among children ages 10 to 14 and 333 percent among adolescents ages 15 to 19.
“Colorectal cancer is no longer considered just a disease of the elderly population,” said lead researcher Dr. Islam Mohamed, an internal medicine resident at the University of Missouri-Kansas City.
Researchers looked at colorectal cancer rates in children and adults ages 10 to 44 and found that cases had increased in all age groups.
“It means there is a trend,” Dr. Mohamed said. NBC. “We don’t know what to make of this yet, it could be lifestyle factors or genetics, but there is a trend.”
While cases have skyrocketed, the total number of cases in people under 40 years of age remains low and cases in people under 30 years of age remain rare.
For example, in 2020, the American Cancer Society estimated that there were only 17,930 cases of colorectal cancer in Americans under age 50.
Regarding the case rate, in 2020, only 0.6 children aged 10 to 14 per 100,000 inhabitants were diagnosed with colorectal cancer, compared to 0.1 per 100,000 in 1999.
Diagnoses in adolescents aged 15 to 19 increased from 0.3 to 1.3 per 100,000, and in young adults aged 20 to 24, cases increased from 0.7 to two per 100,000.
Increases were also found in older adults, with rates rising 71 percent to 6.5 per 100,000 people ages 30 to 34 and 58 percent to 11.7 per 100,000 ages 35 to 39 in 2020.
While the 40 to 44 age group had a smaller percentage increase of 37 percent, the group had the highest incidence rate, reaching 20 per 100,000 people in 2020.
The incidence rate is the number of new cases of a disease divided by the number of people at risk of having it.
When rates are low to begin with, any increase can be significant.
“When you start with a very rare disease in 15-year-olds and add a couple of cases, you have a huge percentage increase,” said Dr. Folasade May, an associate professor of medicine at the University of California. Vatche and Tamar Manoukian, Los Angeles Division of Digestive Diseases, told NBC.
Erin Verscheure was 18 years old when she was diagnosed with stage four colorectal cancer. It was 2016 and she had just graduated from high school when she noticed blood in her stool.
Ms Verscheure underwent a bowel resection, which is an operation to remove part of the small intestine, large intestine or both, followed by 12 rounds of chemotherapy. In August 2017, she was told that she was in remission.
Evan White, of Dallas and the oldest of three children, was diagnosed with stage three colon cancer at the age of 24 after going to the hospital to have a tonsil abscess removed. He appears in the photo above at Christmas with his then puppy, a Bernese Mountain Dog, named Lola.
Dr. May added that while the overall increases are concerning, it is reassuring to see that the oldest age group had the smallest percentage increase, because people ages 40 to 44 had the highest number of cases to begin with.
One of those teens is Erin Verscheure, who was 18 when she was diagnosed with stage four colorectal cancer.
It was 2016 and he had just graduated from high school when he noticed blood in his stool.
“Honestly, I didn’t know colorectal cancer existed, so I never looked into it and I was diagnosed very quickly,” she said.
One day, the bathroom was completely full of blood, which left her “quite worried”, so she went to the doctor to have her blood tested.
‘I couldn’t believe this had become my life. He was supposed to be an 18-year-old recent graduate, he had this whole new world ahead of him. But the hospital stays and the chemotherapy chair consumed me and took away part of my life.’
At first, doctors told him it was just a severe case of salmonella that would go away on its own, but then they decided he should see a specialist for a colonoscopy, after which he was diagnosed with the disease.
He underwent an intestinal resection, which is an operation to remove part of the small intestine, large intestine, or both, followed by 12 rounds of chemotherapy.
In August 2017, she was told she was in remission.
Meanwhile, Evan White, 24, of Dallas, had just graduated with a degree in finance from the University of Arkansas when he was diagnosed with colon cancer after months of dismissing his main symptom, fatigue.
The tumor was not detected until it progressed to stage three, meaning it had spread outside the colon, making it much more difficult to treat.
White was on track to marry his girlfriend and move to California, but his dreams were cut short when he died after a four-year battle with the disease.
Experts aren’t sure what’s behind this unprecedented rise and are exploring whether modern diets, antibiotics or even fungal infections could be at play.
Colorectal cancer usually begins as a small growth, called a polyp, on the inner lining of the colon or rectum, part of the large intestine.
Over time, the cells in these polyps can begin to divide uncontrollably, triggering cancer.
It often causes no or very few symptoms in the early stages, which is why doctors say everyone age 45 and older should be screened for cancer once a decade. It is also possible to have an exam at a young age after talking to doctors.
Early warning signs of the disease may include a change in bowel habits, blood in the stool, unexplained weight loss, and sudden fatigue or weakness caused by blood loss.
If caught in the early stages, before it spreads to other areas, the charity Fight colorectal cancer says nine out of ten patients will live more than five years after their diagnosis.
But if the cancer is not detected until the third stage, the five-year survival rate drops to 71 percent. In the fourth stage, only 14 percent of patients live another five years.