As a lifelong vegetarian who ran every day and never called in sick to work, Laurie Koshers doesn’t fit the bill for a cancer patient.
However, in 2018, doctors told the North Carolinian there were “tumors everywhere” in her intestines and she was diagnosed with terminal colon cancer.
The mother of three was 44 at the time, much younger than the average age of diagnosis for this type of cancer, which is 66, and had no family history of the disease.
But she is one of a growing number of people being diagnosed with early-onset colon cancer – cases that occur in people under 50 – and doctors say diagnoses are mysteriously rising at an alarming rate.
Although a definitive answer has not been discovered, experts increasingly blame ultra-processed foods and red meat, as well as obesity and a low-fiber diet.
But doctors say patients like Ms. Koshers highlight that other factors could be behind the rise.
Laurie Koshers, pictured above with two of her children, shared her story as part of the Colon Cancer Coalition’s series to raise awareness about the disease.
Mrs. Koshers was active and ran every day. She also ate healthy and avoided meat.
Laurie said she had hardly ever touched red or processed meat during an interview with the charity Colon Cancer Coalition.
She also said she never called in sick to work unless one of her children got sick with something.
Dr. Cedrek McFadden, a South Carolina oncologist who works with patients with early-onset colon cancer, is among doctors who no longer believe that obesity and red meat explain why so many healthy young adults develop colon cancer.
He told DailyMail.com: “I suspect it will be an environmental agent, maybe there is something about environmental exposure (i.e. before the age of 30 and 40) that leaves the body predisposed to it.”
He said this agent could be a pesticide or a food additive, air pollution or even microplastics from food packaging.
She added: ‘What puzzles me and is equally frustrating for them is that when we talk about risk factors for colon cancer, we talk about obesity, smoking, having a diet high in red and processed meats.
‘But these are patients who participate in running clubs, who have a completely organic diet, who may even be vegan and consume very few meat products.
‘There is some kind of exposure that is occurring in the population – around the 1980s and early 2000s – that is causing this increase.
‘I think it will depend on what we eat or drink and how that alters our gut microbiome, although we haven’t fully figured that out yet.
‘It could be food additives or pesticides, but I definitely think there won’t be one single culprit, it will be more of a cumulative effect.
‘So the effect of having too many parts per million or billion of one pesticide and then this other additive and then together these could lead to excessive mutations in cells that cause cancer.’
Dr. Suneel Kamath, an oncologist at the Cleveland Clinic in Ohio, said red meat and processed foods were likely behind many cases, although he also believed other factors were causing the disease.
In 2018, Laurie began experiencing bloating and irregular bowel movements, but attributed it to a gluten sensitivity and aging.
After experiencing severe abdominal pain, she went to the doctors, who diagnosed her with irritable bowel syndrome (IBS) and a ruptured abscess.
It was only after she collapsed in the bathroom and was rushed to hospital that a large tumour was detected in her colon.
Doctors removed 30 centimetres of her colon and the tumour in an operation, saying she had stage three cancer and ordering three months of chemotherapy.
But at her next check-up she was told the cancer had progressed to stage four, when it had spread from her colon to numerous areas of her abdominal cavity.
Doctors said they could see so many growths on a scan of her abdomen that it looked as if someone had “taken a salt shaker and spread cancer all over” her body.
He is currently participating in a clinical trial at Duke University. While the drugs are not expected to eradicate the cancer, they are expected to delay it, allowing him to spend more time with his family.
In a similar situation, Irena Aitrop, 72, of Florida, also a lifelong vegetarian, was diagnosed with colon cancer in July.
She revealed her diagnosis in a Facebook post, writing‘I still find it hard to believe that, being a vegetarian and mostly vegan, I can develop colon cancer. This is why I always avoided having a colonoscopy.
‘(But now) I’m regretting my stupidity and… I’m just asking everyone to go ahead and schedule their colonoscopy if they’re over 45 or haven’t had one yet.’
Ms Aistrop was diagnosed in early July and sent for surgery in August to remove the tumour that had been found in her colon, but had not spread.
Ms Aistrop, pictured above, said she did not believe she could develop cancer because of her dietary choices.
There has been a lot of research into what may be behind the colon cancer epidemic in young adults.
Several studies have suggested there may be a link to eating “too much sugar” and too little fibre, with researchers suggesting this could speed up the ageing of gut cells and make them more prone to cancer.
Others have even suggested that having older siblings could leave someone at higher risk, because it can expose children to diseases earlier and cause inflammation in the gut, predisposing them to cancer later in life.
Previously, doctors had suggested that red meat and diets high in processed foods were responsible for the rise: A 2015 Harvard paper found that vegetarians had a 22 percent lower risk of colon cancer compared with meat eaters, while a 2023 meta-analysis of eight studies said they had a 23 percent reduced risk.
Other studies have also focused on red meat, with one suggesting that eating half a steak every day for six years may increase the risk of bowel cancer by a fifth.
But experts were quick to express skepticism about the research.
Many studies on red meat fail to clarify that those who eat a lot of red meat also tend not to eat enough servings of essential fruits, vegetables and whole grains, which could put them at greater risk for adverse health problems. Vegetables are high in fiber, which is key to promoting healthy digestion.
And a 2020 study published in Cambridge University Press found that meat eaters are more likely than vegetarians to be overweight or obese.
Irena Aistrop of Florida had been a lifelong vegetarian and sometimes vegan, so she was shocked when she was diagnosed with colon cancer.
Countless high-quality studies have shown that regardless of diet, carrying excess weight, especially around the midsection, can increase the risk of a range of cancers, including bowel and stomach cancers, making it difficult to determine with certainty whether meat or another lifestyle component is causing the cancer.
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 by 333 percent among adolescents ages 15 to 19.
Researchers looked at colorectal cancer rates in children and adults aged 10 to 44 and found that cases had increased across all age groups.
The study also found that rates rose 71 percent to 6.5 cases of colon cancer per 100,000 people ages 30 to 34 over the two-decade study period, and 58 percent to 11.7 per 100,000 people ages 35 to 39 in 2020.
Authorities are now beginning to order new studies to investigate what is behind this growing trend.