Taking a rise in colorectal cancer seriously

Stuart J. Braverman, MD headshot

In 1985, then-president Ronald Reagan underwent a life-saving surgery to remove a cancerous polyp in his large intestine. The polyp was discovered during a colonoscopy, which was the only screening test at that time that detected and prevented colon cancer.

The attention created by President Reagan’s test and surgery led to the first screening recommendations in the United States in the mid-1990s. At that time, all adults over the age of 50 were suggested to receive regular colonoscopies, which check for polyps inside the rectum and the entire colon.

In 2018, the American Cancer Society (ASC) was the first health organization to lower the age for regular colorectal cancer screening from 50 to 45. Driving this decision was research evidence that the risk of developing colorectal cancer at younger ages was increasing.

According to the ASC, the rates of people, mostly older, getting colon or rectal cancer have decreased, yet the incidence rates of people younger than 55 have been increasing by 1-2% each year since the 1990s, and deaths in that age group have been increasing since the mid-2000s.

In a report released by the ASC in January, colorectal cancer is now the primary cause of cancer-related deaths among young men under 50 and the second leading cause among women in the same age group.

Younger people aren’t supposed to get colon cancer, right? Thirty years ago, the average age of my patients with colon cancer was 75; now, it’s closer to 60, and I’m seeing more patients in their 50s with the disease. My youngest patient was 22, and I’ve treated others in their 30s and 40s.

While experts aren’t sure why there’s an increase in younger adults getting colon and rectal cancer, being overweight and physically inactive, having Type 2 diabetes, eating a diet high in processed food or red meat, and smoking or drinking alcohol may be contributing factors. Fortunately, these are lifestyle decisions that can be changed.

Even with the lower recommended age for colon cancer screenings, younger adults aren’t routinely screened because the disease is still relatively rare in their age groups. Yet, colon cancer has warning signs that should never be ignored. They include abdominal or pelvic pain, a change in bowel patterns, bleeding, stomach bloating, fatigue or weakness due to anemia that silent colonic bleeding may produce or unexplained weight loss.

The best way to prevent colorectal cancer is living a healthy lifestyle by being active, managing your weight, eating a diet high in fruits and vegetables and not smoking. The other half of prevention is getting regular screenings, which doesn’t mean just getting a colonoscopy.

Each year, during your physical exam, you should receive a digital rectal exam and a test that checks for occult (hidden) blood in the stool. Colonoscopies should begin at age 45 unless special circumstances or symptoms exist and continue every five to 10 years depending on your age and risk factors. Polyps can also be removed during the procedure before they become cancerous.

The bottom line (pun intended) is colorectal cancer is no longer a disease of older people. Talk to your doctor about any suspicious symptoms at any age and keep your rear in gear with healthy living and regular screenings.

Dr. Stuart Braverman is Chief of Staff at Bothwell Regional Health Center. As chief, he provides leadership and guidance to the medical staff and promotes effective communication between the medical staff, administration and the Board of Trustees. Dr. Braverman is from Sedalia and has been a general surgeon for 32 years at Surgical Services of Sedalia. He’s treated thousands of patients in the clinic and at the hospital.