Colorectal Cancer
Stan, Clarence, Barry, and the Health Chatter team chat with Dr. Logan Spector, pediatric cancer epidemiologist at the University of Minnesota, about early onset colorectal cancer and what’s driving its rise in younger populations.
Dr. Spector specializes in understanding the causes of childhood cancers, including leukemia, bone sarcomas, and hepatoblastoma, using both traditional and genetic epidemiologic approaches. He has led or collaborated on numerous National Cancer Institute–funded studies and currently serves as Chair of the Childhood Cancer and Leukemia International Consortium (CLIC), a global effort to better understand cancer causes. Through his work with the Children’s Oncology Group and international partners, Dr. Spector focuses on uncovering patterns, risk factors, and prevention strategies to improve early detection and long-term outcomes.
Learn more about Dr. Spector and his work here
Join the conversation at healthchatterpodcast.com
Brought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships.
More about their work can be found at https://www.huemanpartnershipalliance.org/
Research
Early-onset colon cancer, also called young-onset colon cancer, is defined as colon cancer diagnosed before age 50.
Colon cancer usually begins as small clumps of cells called polyps that form in the section of the large intestine called the colon.
Rectal cancer starts as a growth of cells in the last several inches of the large intestine, called the rectum.
Cancer inside the rectum and cancer inside the colon are often referred to together as colorectal cancer.
Recent findings
Dr. Cao is leading a first-of-its kind research program called PROSPECT that’s investigating the causes of early-onset colorectal cancer
Funded by NCI, Cancer Research UK, Bowelbabe Fund, and Institut National du Cancer through the Cancer Grand Challenges program, PROSPECT is international in scope, and with good reason, she explained during a December 2024 NCI advisory board meeting.
One recent study, found that nearly 10% of new colorectal cancers around the world are in people under the age of 50.
And a study by American Cancer Society (ACS) researchers revealed that early-onset colorectal cancer rates have increased in 27 of the 50 countriesExit Disclaimer included in their analysis.
Early-onset colorectal cancer has historically been highest among American/Alaskan Natives and African Americans. While the rates among those populations have remained steady, early-onset colorectal cancer has been increasing among White adults.
Risk factors
diet - eating a "western" diet that is low in fruits, vegetables, and fiber or a diet that is high in fat and processed meats is associated with a higher risk of CRC
tobacco use - smoking is associated with an increased risk of colorectal cancer
drinking alcohol (alcohol consumption)
lack of regular exercise (physical inactivity, sedentary lifestyle)
overweight and obesity
inflammatory bowel disease (ulcerative colitis, Crohn's disease, IBD)
family history of colorectal cancer, especially in a first-degree relative
Chances of getting colon cancer
The average risk of getting colon cancer when you're younger is still low but rising.
In the early 2000s, about 5% to 7% of colon cancer diagnoses were considered early onset.
Now, around 10% of colon cancer diagnoses happen in people younger than 50. Most of these diagnoses happen between the ages of 40 and 49.
The risk of being diagnosed with colon cancer by decade:
20s: About 2.3 people in 100,000.
30s: About 6.4 people in 100,000.
40s: About 19.2 people in 100,000.
Symptoms
Common symptoms to look for include:
Rectal bleeding. Almost half of young people with colon cancer have rectal bleeding. Blood in your stool or on toilet paper may be a sign.
Stomach pain or cramping that doesn't go away.
Changes in bowel habits, such as new or lasting constipation or diarrhea.
Feeling very tired or weak, which may be caused by low iron.
Weight loss without trying.
Bloating or feeling full soon after eating.
Nausea or vomiting.
Prognosis for colon cancer in young adults
The prognosis of early-onset colon cancer can vary depending on a few factors, including:
Stage at diagnosis. Young adults diagnosed in earlier stages of colon cancer have a much better prognosis compared with those diagnosed at stages 3 or 4. Early-onset colon cancer is often diagnosed at more-advanced stages. This is often due to delayed recognition of symptoms, which can worsen prognosis.
Type of cancer cells. Colon cancer in younger people often is more aggressive. Despite this fact, many young adults usually survive just as long, or even longer, than older adults when they are treated at the same stage.
Treatment response. Younger people often receive more-aggressive treatments, including surgery and chemotherapy, and typically tolerate these therapies better than do older adults.
Genetic differences. Unique genetic profiles in young adults may influence cancer cell behavior and treatment response. However, this is still being studied.
Reduce Risk
Some studies suggest that people may reduce their risk of developing colorectal cancer by:
Increasing physical activity.
Keeping a healthy weight.
Eating a diet low in animal fats and high in fruits, vegetables, and whole grains.
Limiting alcohol consumption.
Avoiding tobacco.
Screening.
Knowing family medical history.
References
https://www.globalcca.org/learn/early-onset-colorectal-cancer
https://www.cdc.gov/colorectal-cancer/prevention/index.html
