Overall cancer mortality in those younger than 50 years old in the United States is decreasing — although there has been an increase in deaths from colorectal cancer. It is now the leading cause of cancer deaths in that population.
According to a study published in JAMA, cancer deaths in the under-50 crowd decreased in total by 44%, — from 25.5 per 100,000 people in 1990 to 14.2 in 2023. Colorectal cancer deaths, though, have gone up by 1.1% per year since 2005.
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“The steady rise in colorectal deaths under 50 is even more alarming compared to the dramatic declines for lung and breast, even as breast cancer incidence is climbing,” Dr. Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society and the lead author of the report,said in a statement. “While we await answers for why colorectal cancer rates are up, lives can be saved now through symptom awareness and destigmatization, and more screening uptake, as three in four people under 50 are diagnosed with advanced disease.”
Having an “advanced disease” means it’s harder to treat — and more deadly, Michael Sapienza, the chief executive officer of the Colorectal Cancer Alliance, told Straight Arrow News.
“How do we find out number one: why this is happening, and then number two, how do we treat it?” Sapienza said.
No longer an ‘old person’s disease’
Dr. Ahmedin Jemal, senior vice president of surveillance, prevention, and health services research at the American Cancer Society and senior author of the study, said researchers weren’t expecting colorectal cancer to rise to this level so quickly.
“Now it is clear that this can no longer be called an old person’s disease,” Jemal said. “We must double down on research to pinpoint what is driving this tsunami of cancer in generations born since 1950.”
Data researchers used was from the National Center for Health Statistics as provided by the Surveillance, Epidemiology and End Results (SEER) program at the National Cancer Institute.
According to their findings, there was an average annual decline of 0.3% for brain cancer; 1.4% for breast cancer; 2.3% for leukemia and 5.7% for lung cancer. Breast cancer is still the second leading cancer death, and first for women.
Misdiagnoses muddy the waters
The American Cancer Society recommends most people start screening for colorectal cancer at the age of 45.
A survey by the Colorectal Cancer Alliance shows that about 82% of young-onset colorectal cancer survivors were initially misdiagnosed — and many had to see multiple doctors before getting a correct diagnosis.
Some things patients were told, Sapienza said, include: “You have hemorrhoids, go home and take Metamucil,” or “Your diet is off,” or “You may have bleeding because there’s a tear.”
This is why, he says, “we need to fund, fund, fund research in the colorectal cancer space” and make sure people, if they have symptoms, demand a colonoscopy when they go to their primary care or gastroenterology doctor, even if they are under 45. These symptoms include: a change in bowel habits; rectal bleeding or blood in the stool; ongoing cramps, gas or pain in the belly area; weakness or tiredness and losing weight without trying, according to the Mayo Clinic.
“It’s vital,” he added.
Researchers are looking into multiple reasons colorectal cancer mortality is rising in younger people such as diet, exercise, lifestyle, genetics, environmental factors, Scientific American writes, though it notes many say there’s not one single cause.
“Most likely for young onset colorectal cancer, it is what we call multifactorial. There is not going to be one silver bullet,” Sapienza said.
