I HELP INDIVIDUALS WITH CANCER. I am becoming increasingly troubled by the fact that colorectal cancer, once primarily a concern for older adults, is showing a disturbing trend: a rise in diagnoses among young people. Today, we look at young adult colon cancer.
While the reasons behind this shift are still under investigation, new research points to a surprising culprit — the trillions of bacteria living inside our guts, collectively known as the gut microbiome.
This complex ecosystem of microbes plays a crucial role in digestion, immunity, and even overall health.
Gut Flora Imbalance and Young Colorectal Cancer
But could an imbalance in this gut flora be contributing to the increased risk of young-onset colorectal cancer?
This happening isn’t science fiction.
Recent studies have identified specific strains of bacteria that might be associated with colon cancer development.
We can influence our microbiome.
The good news?
We have some influence over the makeup of our gut microbiome.
By understanding how diet, lifestyle, and even medications can impact these tiny residents, we might be able to unlock new strategies for preventing this devastating disease, especially for young adults.
Let’s delve deeper into the fascinating world of the gut microbiome and explore its potential connection to colorectal cancer in young people.
First, a look at the recent rise in colon and rectal cancer among young people.
Young Age and Colorectal Cancer
We often think of colon cancer as a disease affecting older adults. But here’s a wake-up call: colorectal cancer diagnoses are rising in young people, and it’s been happening for years.
As an oncologist, I encourage all of you to be aware of your colon cancer risk and to reach out to your healthcare provider with any concerning symptoms.
Selected symptoms
Don’t ignore rectal bleeding, constipation, or sudden changes in bowel movements.
Early colorectal cancer detection is crucial to minimizing treatment interventions and optimizing outcomes.
Young Adult Colon Cancer is On the Rise
In my clinical practice of oncology, I see an increasing number of young patients with a diagnosis of colorectal cancer.
I have seen a young man in his 30s with rectal adenocarcinoma. And it’s not just me.
According to the American Cancer Society,
- Colon cancer diagnoses in people under 55 have doubled since 1995.
- One in five colorectal cancer diagnoses in 2019 were in patients under age 55. This number is approximately double the rate in 1995.
The numbers are climbing at an alarming rate. A 2021 study estimated that by 2028, colorectal cancer will be the leading cause of cancer deaths in people ages 20 to 49.
But Colon Cancer is Decreasing Among Older Folks
On the positive side, colon cancer rates in older adults (over 65) are going down.
Even though colon cancer is still most commonly diagnosed in people over 65, there’s good news for this age group. The number of new cases is going down.
Moreover, older adults are less likely to be diagnosed with advanced stages of the disease than younger people.
This observation suggests that earlier detection efforts and better treatments make a difference for seniors.
Screening Recommendation Change
Recognition of the rise in young folks has led to a change in recommendations: The U.S. Preventive Services Task Force (USPSTF) and the U.S. Multisociety Task Force on Colorectal Cancer now advise this:
Most people should get screened for colon cancer at age 45, five years earlier than before.
The initiation of screening at 45 (for those at average risk of getting colorectal cancer) is five years earlier than previously recommended.
Young Adult Colon Cancer: Why?
No one knows with certainty why there has been an uptick in young adult colorectal cancer.
Approximately one in five early-onset (before 50) colorectal cancer cases are due to germline gene mutations.
I think some other factors may be playing a role:
- Excessive weight
- Sedentary lifestyle
- Smoking
- Heavy alcohol use
- Diet (low-fiber, high-fat diets, or ones high in processed meats)
- Environmental factors
Of course, when my patient is diagnosed with cancer at a young age, we often suspect genetics.
The most common genetic condition linked to colorectal cancer is Lynch syndrome (especially for tumors in the right colon).
But genetics don’t seem to explain the rise in cases.
Young Adult Colon Cancer: Role of Gut Bacteria?
An early look at genetic data from individuals with colorectal cancer suggests that the cause is linked to what is happening in the gut.
Researchers from Ohio State University (USA) presented some interesting findings at a recent cancer conference in Chicago.
They looked at the genes in colon cancer tumors and found some clues. Their analysis suggests that a diet high in fat and low in fiber might play a role.
This diet type could be causing inflammation in the gut, which might then interfere with the body’s natural ability to fight off tumors.
The cells in young people with colorectal cancer seemed to be “aging” faster than normal. On average, these cells were acting 15 years older than the person’s actual age.
This finding differs from what they see in older adults with the disease.
My Thoughts – Young Adult Colon Cancer
This new study adds to the growing evidence that gut health might play a role in young-onset colon cancer.
Researchers found a connection between a specific type of bacteria called Fusobacterium and the disease in younger patients.
Fusobacterium is normally in the mouth, but it seems to be showing up more often in the intestines of people with colon cancer, especially young adults.
One study even found that people with the microbe were five times more likely to have this bacteria in their stool than healthy individuals.
So, what’s the link? The researchers believe a high-fat, low-fiber diet might promote gut inflammation, creating an environment where Fusobacterium thrives.
This bacteria might interfere with the body’s natural ability to fight off tumors.
The bottom line – Young Adult Colon Cancer
This research suggests a potential connection between diet, gut bacteria, and colon cancer in young adults.
While more investigation is needed, it reminds me of the importance of maintaining a healthy gut through a balanced, fiber-rich diet.
Thank you for reading “Young Adult Colon Cancer.”
Title photo from Adobe Stock Photos.
