The average person under the age of 55 now has roughly the same risk of colorectal cancer as a person born in 1890, according to a paper published February 28, 2017, in the Journal of the National Cancer Institute. Colorectal cancers are on the rise among young people, even as rates have fallen among older adults.
Since the 1980s, colon cancer incidence has increased 1 to 2 percent annually among adults aged 20 to 39. Tracking this population, their colon cancer incidence continued to increase by 0.5 to 1 percent annually as they moved from ages 40 to 54 in the 1990s. From 1989 to 2012, the proportion of rectal cancer diagnosed in adults younger than 55 doubled from 14 percent to 29 percent.
Meanwhile, in adults aged 55 and older, colon cancer rates have generally gone down since 1980, and rectal cancer rates have gone down since 1974. Nearly one third of rectal cancer patients today are younger than 55, yet current guidelines call for initiating colorectal cancer screening at age 50. With the National Cancer Institute (NCI) reporting that colorectal cancer is the third most common type of cancer in the US, it is urgent that we address this situation.
Researchers are unsure why young people are being diagnosed with colorectal cancer at high rates, but as they probe potential factors including diet, sedentary lifestyle, obesity, and environment, public health leaders must act now to respond to this worrying trend. We at the University of Kentucky College of Public Health are working to spread awareness and make screening accessible and practical for people who are at risk.
As part of our long-running partnership with the UK Markey Cancer Center, an NCI-designated research center, the CPH Rural Cancer Prevention Center works with local partners to encourage screening in hard-hit rural populations. The Appalachian Center for Cancer Education, Screening and Support (ACCESS) emphasizes preventive care in Appalachia by partnering with White House Clinics to implement the Proactive Office Encounter (POE) model to encourage cancer screenings (read more about ACCESS in the Winter 2016-2017 College of Public Health Magazine). Preliminary results of the ACCESS project indicate that the POE model may increase screening rates. The RCPC also provides education on colorectal cancers. A critical project involves the distribution of FIT (fecal immunochemical) tests, a home testing option that allows patients to submit stool samples for preliminary screening. FIT is a good choice when geography, funding, or patient comfort are barriers to more extensive colonoscopy or flexible sigmoidoscopy testing.
March is Colorectal Cancer Awareness Month, and the NCI just released the new “Gut Check” tool to assist patients in learning about colorectal cancer screening options. Patients should familiarize themselves with colorectal cancer risk factors and symptoms, and health care providers should consider screening for younger adults.