Colorectal is on the rise in people under 50, and has been for years.
And according to a March review of colorectal cancer statistics published in “CA: A Cancer Journal for Clinicians,” the cause is unknown.
That’s not how they put it, of course.
“Progress against CRC could be accelerated by uncovering the etiology of rising incidence in generations born since 1950 and increasing access to high-quality screening and treatment among all populations, especially Native Americans,” is what the study’s authors wrote in an abstract of their work, but it means largely the same thing: If we want to make progress against this disease, we need to know the cause of its increasing prevalence.
The Washington Post, reporting on the study last month, put it more directly: “No one knows why.”
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What we do know is that in 2019, about one in five cases of colorectal cancer were diagnosed in patients under the age of 55.
That may not sound like a lot, given that about 70.9 percent of the American population was under 55 in 2019, according to Census Bureau statistics.
The problem is that the occurrences had nearly doubled since 1995, from only 11 percent for — again — reasons unknown.
“The rise in early-onset colorectal cancer is driven primarily by cancer forming on the patient’s left side, in the lowest portion of the colon or the adjacent rectum, said Rebecca Siegel, senior scientific director of surveillance research for the American Cancer Society,” the Post reported. “These cases tend to be more advanced than cancers detected in older people.”
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From 2011 through 2020, the overall mortality rate from colorectal cancer fell by about 2 percent each year. However, the study found that it actually increased among patients under 50 and “in Native Americans younger than 65 years” at a rate that varied annually between 0.5 and 3 percent.
“In summary, despite continued overall declines, CRC is rapidly shifting to diagnosis at a younger age, at a more advanced stage, and in the left colon/rectum,” the study’s authors concluded in its abstract.
The Post noted that Americans’ life expectancy had come close to 80 before the pandemic knocked that number down to 76.4 in 2021. While it has been edging upward since, the Post posited a number of possible explanations for what it called “America’s life expectancy crisis.”
The Post cited drug use and “gun violence” as contributing to the cause, although gun deaths per capita, including suicides, were in 2021 “well below” the peak numbers seen in 1974, according to the Pew Research Center. (In fairness, they were up from numbers earlier this millennium.)
Much more significant factors than guns and drugs were “chronic conditions such as heart disease, obesity, diabetes and cancer,” the post reported.
Given that the rise in colorectal cancer among younger people has also been observed in other developed countries, the Post speculated that obesity — and its correlation with “increased consumption of highly processed, low-fiber foods and a lack of exercise” — could be to blame.
However, given that many younger patients are not obese and never were, the Post was forced to refer to the increased cancer rates as a “medical mystery.”
“This is a dramatic increase. And the trends are not going away,” Whitney Jones, a gastroenterologist who founded the Colon Cancer Prevention Project in Louisville told the Post.
“We need to educate all people around colorectal cancer, similar to how we educate women around breast cancer,” he added.
