Colorectal Cancer Rates Rising In Young People

Jeffery Nelson, M.D., FACS, FASCRS, is an experienced colorectal surgeon who serves as Surgical Director of The Center for Inflammatory Bowel and Colorectal Diseases at Mercy. In response to a query from Salon.com, Dr. Nelson offers his insights into the disturbing trend of colorectal cancer rates rising among younger adults—what is behind these rising rates, what symptoms people should look out for, and any promising treatments or prevention tips.

We don’t know exactly what is behind the rising rates of colon cancer in younger people (< 50), but it is almost certainly multifactorial. The western diet and lifestyle are chief culprits. The overall incidence of colon cancer has been dropping steadily over the last 30 years or so, but in the younger age group it has been steadily rising since the mid 1990’s. It remains the third most common cancer killer in both men and women. The main symptoms to look out for are rectal bleeding, any change in bowel habit, abdominal pain, and unexplained weight loss. These are typically late symptoms, however, thus the push to get people screened. The trick is to find colon cancers before they are symptomatic, or preferably when they are just benign polyps. The screening recommendations for average risk individuals has dropped from age 50 to 45 as a response to the rising rate in those under age 50. Chemotherapy regimens continue to improve as do surgical techniques (robotic surgery, trans anal total mesorectal excision, etc). Also, proton radiation therapy as opposed to the traditional photon radiation treatment can improve care in certain cases where tumors need to be targeted more exactly. One other improvement has been the advent of standardized multidisciplinary treatment programs such as NAPRC (National Accreditation Treatment Program for Rectal Cancer - we have this at Mercy) have also been shown to improve outcomes (albeit just for rectal cancer) for patients diagnosed with rectal cancer through strict adherence to standards.

--Jeffery Nelson, M.D., FACS, FASCRS

Dr. Jeffery Nelson is board certified in both General Surgery and Colon Rectal Surgery. His areas of interest include colorectal cancer, rectal bleeding, hemorrhoidectomy and diverticulitis. He brings special expertise in rectal prolapse, ulcerative colitis and complex anal pathology. The Center for Inflammatory Bowel and Colorectal Diseases at Mercy is part of The Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore, MD.