Experts have recently shed light on the concerning rise of late-stage colon cancer among young adults. This alarming trend has led to early onset colorectal cancer becoming the leading cause of cancer-related deaths for men under 50 and the second leading cause for women in the same age group in the United States. With over 50,000 Americans expected to die from colorectal cancer this year and approximately 150,000 projected diagnoses, the situation is dire.
Although cases among younger individuals still represent a minority, experts are increasingly worried about the uptick in diagnoses. Estimates suggest that around 2,600 new cases will emerge among those under 50 in 2024. Alarmingly, studies indicate a staggering 185 percent rise in cases for individuals aged 20 to 24 and a 333 percent increase among teenagers aged 15 to 19, based on data collected by the CDC. Projections also indicate that cases are likely to double between 2010 and 2030, following a consistent two percent annual increase since the early 2000s.
Researchers from the Dana-Farber Cancer Institute and Harvard Medical School have found that young patients with early-onset colorectal cancers frequently experience significant delays in diagnosis. These delays occur because neither physicians nor patients initially suspect the disease. Consequently, many young adults are diagnosed at advanced stages, which often leads to aggressive treatment options and diminished survival chances.
Several factors contribute to the delay in diagnosis, including non-obvious symptoms, a lack of routine screenings, and the potential for misdiagnosis with conditions such as irritable bowel syndrome (IBS) and Crohn's disease. This lack of awareness and screening can lead to critical setbacks in timely treatment. Furthermore, young adults face unique challenges that complicate their medical journeys, such as infertility, medical debt, and mental health issues.
According to John Hopkins University, most colorectal cancers initially develop as colon polyps—typically non-cancerous tumors in the colon wall. These can be effectively removed during colonoscopy procedures. However, if left untreated, these polyps can transform into cancerous growths. Notably, colorectal cancers often present no symptoms in their early stages, underscoring the importance of regular screening tests. The CDC recommends that individuals start getting colonoscopies at age 45, with follow-ups every five years. Those under 45 with conditions like Crohn's disease or a family history of colon cancer should also seek testing. Yet, the CDC lacks recommendations for young individuals experiencing symptoms without a family history, which often leads to delayed diagnoses.
The toll of a cancer diagnosis on young adults can be particularly significant. Despite being in their prime earning years, many young patients encounter severe financial hardship due to treatment costs. A 2024 survey by the American Cancer Society Cancer Action Network revealed that nearly half of cancer patients and survivors carry medical debt exceeding $5,000, even among those with insurance. Additionally, those with cancer-related debt are three times more likely to fall behind on recommended screenings. The survey also indicated that 27 percent of respondents with cancer-related debt have gone without adequate food, while 25 percent have delayed or skipped necessary medical care.
Although official guidelines for early-onset and average-onset cancers remain the same, younger patients often receive aggressive treatment for colon cancer without a demonstrated survival advantage. Such treatments can adversely affect fertility, as excessive radiation may damage reproductive cells and tissues. The American Society of Clinical Oncology advises that oncologists discuss fertility concerns with patients of reproductive age, yet a recent study found that 50 percent of patients reported inadequate communication regarding the impact of their treatment on future fertility. This gap in care can significantly affect the quality of life for young adults.
Research indicates that survivors of early-onset colorectal cancer often report heightened anxiety, body image issues, and sexual dysfunction compared to their counterparts diagnosed at an older age. Moreover, young male patients are more prone to depression than those diagnosed later in life. Consequently, researchers emphasize the need for a deeper understanding of the underlying causes of this disease, improved screening strategies, and enhanced support for young cancer survivors.
This study, which highlights these pressing issues, was published in the BJS journal by Oxford University Press. As the incidence of early-onset colorectal cancer continues to rise globally, it is crucial to prioritize research efforts focused on effective screening, prevention, and treatment strategies.
