Colorectal Cancer Awareness: Deaths Rising Among Younger Adults

by Dr. Therese Kerwel

Colorectal cancer has become the leading cause of cancer-related death among adults under 50 in the United States, according to research published in the Journal of the American Medical Association (JAMA). While overall cancer outcomes have improved for younger Americans, colorectal cancer is the exception.

Since 2005, death rates from colorectal cancer among people under 50 have increased by about 1% each year. This contrasts with broader progress in cancer care. According to the American Cancer Society (ACS), overall cancer deaths among people younger than 50 have declined by about 44% over the past several decades due to advances in screening, prevention, and treatment. The rising mortality associated with colorectal cancer highlights the need for greater awareness, prevention, and early detection.

The ACS estimates that more than 158,000 people in the United States will be diagnosed with colon or rectal cancer in 2026. Researchers continue to study why cases are increasing among younger adults. Potential factors include dietary habits, obesity, sedentary lifestyles, and environmental influences. Because colorectal cancer typically develops slowly, early detection can significantly improve survival outcomes.

Screening and Early Detection Save Lives

Screening remains one of the most effective tools for preventing colorectal cancer and detecting it early. Screening tests can identify and remove precancerous polyps - abnormal growths in the colon or rectum - before they develop into cancer. These polyps often take 10 to 15 years to become cancerous, providing a critical window for prevention.

In response to rising rates among younger adults, the U.S. Preventive Services Task Force (USPSTF) updated its screening recommendations in 2021. Adults at average risk are now advised to begin routine colorectal cancer screening at age 45 rather than 50.

Despite these updated guidelines, screening participation remains low. Only about 37% of adults ages 45 to 49 are up to date with recommended screening tests. As a result, many cancers are diagnosed at later stages. Nearly three-quarters of colorectal cancer cases in people under 50 are discovered after the disease has already advanced, making treatment more complex and reducing survival rates.

Preventative Screening Options

Several screening options are available, and patients should discuss the best choice with their healthcare provider based on personal risk factors and family history. The CDC lists these options:

• Colonoscopy: A flexible tube is used to examine the entire colon and rectum for polyps or cancer. Polyps can often be removed during the procedure.
  
  
• At-Home Stool Tests: These tests involve collecting a stool sample at home and sending it to a healthcare provider or laboratory for analysis.
  
  
• Flexible Sigmoidoscopy (Flex Sig): A shorter tube is used to examine the rectum and lower portion of the colon for abnormal growths.

Addressing Risk Factors and Health Disparities

Certain populations face higher risks. African Americans have the highest incidence and mortality rates, and studies show they are about 20% more likely to be diagnosed with colorectal cancer and 40% more likely to die from it compared with other groups. Differences in access to screening and care contribute to these disparities.

Lifestyle factors also influence risk. The ACS estimates that more than half of colorectal cancer cases and deaths could potentially be prevented through healthier habits.

• Diet: Eat more fruits, vegetables, and whole grains, while limiting red and processed meats.
  
  
• Exercise: Regular physical activity can reduce colorectal cancer risk by 30-40%.
  
  
• Healthy Weight: Maintaining a healthy weight lowers both risk and mortality.
  
  
• Quit Smoking and Limit Alcohol: Smoking increases risk, and heavy alcohol consumption raises colorectal cancer risk by about 50%.

Early symptoms may include changes in bowel habits, blood in the stool, persistent abdominal discomfort, unexplained weight loss, fatigue, or anemia. However, colorectal cancer often develops without symptoms in its early stages.

For this reason, clinicians emphasize proactive screening and prevention to improve early detection and treatment outcomes.

Comprehensive Cancer Care at Ascension Wisconsin

Ascension Wisconsin is dedicated to providing comprehensive colorectal cancer care. The hospital system has earned the National Accreditation Program for Rectal Cancer (NAPRC) accreditation from the American College of Surgeons Commission on Cancer (CoC), distinguishing it as a leader in cancer care. With a multidisciplinary approach, Ascension aims to standardize and improve care, helping to improve patient outcomes. It is one of fewer than 100 hospitals nationwide and the third in Wisconsin to earn this prestigious accreditation.

Dr. Therese Kerwel is a surgeon with Ascension Medical Group Wisconsin. She is board-certified in both colon and rectal surgery and general surgery. To make an appointment call 262-785-7740.