Earlier this year, a study found an upward trend in colorectal cancer rates among young adults in their 20s and 30s. At the time, some scientists were skeptical, arguing that the numbers reflected a rise in early diagnosis of colorectal cancer, and that early diagnosis actually helped these patients. Schematic of the localized spread of colon cancer However, a new study has recently come out that shows some worrying data. The study found that not only is the incidence of colorectal cancer on the rise in the younger population, but the probability of dying from colorectal cancer has also been on the rise in recent years. The study analyzed data on colorectal cancer patients in the U.S. from 1970 to 2014, and they found that while death rates due to colorectal cancer have declined overall, among people aged 20 to 54, the death rate for colorectal cancer rose from 3.9 cases per 100,000 people in 2004 to 4.3 cases per 100,000 people in 2014. Although the change is very subtle, the number may reflect a trend toward younger colorectal cancer patients, and scientists aren’t sure of the reasons behind it. Lifestyle, environmental and genetic factors may all contribute to an increased risk of colorectal cancer, with obesity, a diet with a high proportion of red or processed meat, and a lack of physical activity all being possible factors. The latest research has also identified new risk factors, such as the fact that long-term use of antibiotics may alter the composition of the intestinal flora, which leads to a rise in the likelihood of colorectal polyps, which may become cancerous. Scientists are also trying to find out whether colorectal cancer is different in young and older patients, and whether different diagnostic and therapeutic approaches should be used for the two. Dr. Otis Brawley, chief medical officer of the American Cancer Society, noted that there is evidence that precancerous polyps in younger people are less likely to be detected and removed by colonoscopy because they are flatter rather than tubular. Colorectal Cancer Rates on the Rise in the Younger Population The results of this study illustrate the urgent need for early diagnosis of colorectal cancer in the younger population. Most healthcare organizations now recommend that people over the age of 50 begin regular colorectal cancer screening unless you have a family history or are at high risk for chronic gastrointestinal disease. In the United States, African Americans are advised to begin regular screening as early as age 45 because they have a higher risk of colorectal cancer than whites. One approach would be to start regular colorectal cancer screening in all people, but this would be very expensive and certainly controversial. However, this would be very expensive and certainly controversial because the vast majority of colorectal cancer patients are still elderly. In addition to the price factor, screening by colonoscopy, the most commonly used tool, would be difficult because the number of young people with colorectal cancer, including even precancerous polyps, is still very small. Most will suffer through colonoscopies for nothing, and the process may also cause additional harm. Statistics show that nearly 2 percent of patients need to be admitted to a hospital or emergency room for additional treatment within a week of undergoing a colonoscopy due to complications. Common injuries include tears in the colon and rectal wall, which can be life-threatening in severe cases. 2. Other non-invasive tests are also recommended Although many doctors consider colonoscopy to be the gold standard for colorectal cancer screening, the Preventive Services Task Force established by the U.S. Department of Health and Human Services recommends other non-invasive tests. These include stool sample testing to look for trace amounts of bleeding or DNA mutations, although stool tests are required more frequently and patients will still need a colonoscopy to confirm a positive result. Other tests have their own advantages and disadvantages, with some being less accurate and some producing false positives, and Dr. Brawley believes there is enough evidence to support the effectiveness of fecal testing that some patients will be able to benefit from a noninvasive testing method. Most physicians are still uncomfortable testing for colorectal cancer in a young population because they rarely come into contact with such young patients. Dr. Thomas Weber, a member of the National Colorectal Symposium Steering Committee and a professor at the State University of New York, said that his organization is making a big push to promote colorectal cancer awareness and that “we need to lower the triggering criteria for screening to check for symptoms and rule out malignancy.” 3.How can we increase our vigilance about colorectal cancer? So how can everyone, especially young people, be more vigilant about colorectal cancer? Signs of colorectal cancer include rectal bleeding, bloody stools, unexplained weight loss, fatigue, indigestion, and frequent irregular bowel movements. For men, anemia is also a warning sign that further testing is needed. In women, the symptoms of anemia can be associated with menstruation, but if there is anemia coupled with other symptoms, colorectal cancer screening should also be performed. It is also important to know the family history to keep track of the risk of colorectal cancer. This includes not only cases of colorectal cancer in relatives, but it is also helpful for the doctor to know if there are colorectal polyps, whether benign or precancerous. In addition, other conditions, such as inflammatory bowel disease, can increase the risk of colorectal cancer. More importantly, adopting a healthier lifestyle will help reduce the risk of colorectal cancer, and doctors recommend maintaining a healthy weight, engaging in moderate exercise, eating a healthy diet, not smoking, and avoiding excessive alcohol consumption.