Colorectal cancer is coming after the under-50 generation at accelerating rates, leaving medical communities across the U.S. studying the data to reverse the trend. One factor they pointed to with certainty was the environment and the Western lifestyle, as being closely linked to the uptick in Colorectal cancer.
A disease once associated with older people and previously considered just another side effect of aging and the American lifestyle, today, colorectal cancer may be the leading cause of cancer deaths in adults under 50 in the U.S. It’s the third most common cancer diagnosed in both men and women in the world, according to a paper in the National Library of Medicine.
According to CancerCenter.com
- From 1995 to 2019, new cases of colorectal cancer nearly doubled from 11 percent to 20 percent for Americans younger than 55.
- The disease has become the leading cause of cancer deaths for Americans 20 to 49 years old, according to the National Cancer Institute.
- The average age of a patient diagnosed with colorectal cancer fell from 72 in 2001-02 to 66 in 2015-19.
March is Colon Cancer Awareness Month
March is Colon Cancer Awareness Month, and Hackensack Meridian Health is sounding the alarm on this startling shift, tragically highlighted by the recent death of Dawson Creek Actor James Van Der Beek, 48, on Feb. 11, HMH said in a press release.
Following his diagnosis with Stage 3 colorectal cancer in November 2024, he became an advocate for awareness. He emphasized the importance of early screening, especially as rates rise among younger adults. He is survived by his wife, Kimberly Van Der Beek, and six children, Olivia, Joshua, Annabel, Emilia, Gwendolyn, and Jeremiah.
Key Reasons for the Rise in Young Adults
The World Health Organization recently studied Monographs evaluating the consumption of red meat and processed meat. The International Agency for Research on Cancer (IARC), the cancer agency of the World Health Organization, concluded that each 50-gram portion of processed meat eaten daily increases the risk of colorectal cancer by 18%, according to a WHO press release.
Colorectal cancer is the third most commonly diagnosed cancer, according to the American Cancer Society. Roughly 1 in 5 new colorectal cancer diagnoses now occur in patients under 55, a rate that has nearly doubled since the mid-1990s. Colorectal cancer is now the leading cause of cancer death for men under 50 and the second for women in the same age group.
HMH outlined some basic reasons for the spike in the younger demographic:
●“Birth Cohort” Effect: Researchers believe that environmental exposures during early life or development for specific generations (Gen X, Millennials, Gen Z) have increased their susceptibility. , who passed away at 48 after a battle with the disease.
●Diet and Lifestyle: A shift towards Westernized diets, often higher in processed foods and lower in fiber, combined with more sedentary lifestyles. High consumption of sugar, processed foods, red meat, and a lack of fiber are primary suspects.
●Gut Microbiome Changes: An imbalance in gut bacteria, or dysbiosis, can create a pro-inflammatory state that encourages tumor growth. Specific bacterial strains, such as E. coli that produce the toxin colibactin, have been found to damage DNA.
●Obesity and Metabolic Health: The rise in obesity and diabetes is linked to increased risk. Studies suggest young adults with colorectal cancer are, on average, biologically 15 years older than their chronological age.
●Environmental Factors: The impact of various environmental factors on our gut health is an area of active investigation. Exposure to microplastics and increased use of antibiotics over the past decades may be affecting gut health.
New Screening Recommendations
More than 154,000 Americans will receive a colorectal (colon) cancer diagnosis this year, making it the fourth most common cancer affecting men and women, according to the American Cancer Society (ACS). It’s also one of the most preventable cancers.
“Typically, one in five colorectal cancer patients coming to our office is under age 50,” said David B. Greenberg, MD, FACP, chief of hematology/oncology at Hackensack Meridian Jersey Shore University Medical Center.
“Sometimes it’s two out of every five. What’s even more concerning is that many of these young patients are otherwise healthy with no known obvious risk factors or genetic disposition,” Dr. Greenberg said.
The rise in cases among younger adults has led to updated screening recommendations, with the American Cancer Society now advising that screening for individuals at average risk begin at age 45. However, a significant challenge remains in diagnosing the disease in its early stages among younger individuals, as symptoms are often dismissed or misattributed to other conditions. This delay in diagnosis can lead to the cancer being more advanced and challenging to treat when it is finally discovered.
Biggest Contributing Factor: Environment and Lifestyle
This Colon Cancer Awareness Month, Hackensack Meridian Health wants to help rewrite the narrative. It’s time to raise awareness that age is no longer a reliable shield against this disease.
“For years, symptoms in younger adults might have been attributed to more benign conditions. Now, there is a much lower threshold to investigate for colorectal cancer. We encourage primary care physicians and specialists to consider colonoscopy for symptomatic patients under 45 more readily,” said Steven Lee-Kong, MD, chief of Colorectal Surgery, Hackensack University Medical Center.
About 90% of cancers are caused by environmental and lifestyle factors, not genetics, with major contributors including
🚬Tobacco
🍨Poor diet
☀️Alcohol
⛹🏼Lack of exercise
🐖Obesity
☀️Sun exposure
🧪Certain infections
🧪Environmental factors
It’s not a single factor that’s the problem; it’s a collection of these risks. Lifestyle choices — such as smoking cessation, healthier eating (fruits and vegetables), and sun protection — are key to prevention.
For every 10 grams of fiber a person eats each day, colorectal cancer risk is lowered by up to 10%, according to the Physicians Committee for Responsible Medicine.
“The good news is, more people are getting screened for colorectal cancer and are doing more to address lifestyle risks,” said Michael Caparelli, MD, MS, FACS, colorectal surgeon at Hackensack Meridian Southern Ocean Medical Center.
“Colonoscopy is an excellent screening tool that can identify and remove polyps before they develop into cancer. It is also beneficial in finding colorectal cancer at an earlier stage when it is easier to treat,” Dr. Caparelli said.
The Challenge: Education and Follow Through
A survey from the Physicians Committee for Responsible Medicine and Morning Consult found that nearly half of Americans are unaware that eating processed meat raises the risk of colorectal cancer.
After being informed that processed meat consumption increases colorectal cancer risk, two-in-three survey respondents said they would support adding warning labels on processed meat products.
Those following a plant-based diet had a 22% lower risk for all types of colorectal cancers compared with those who consumed an omnivorous diet. Plant-based diets may be especially protective because fruits, vegetables, whole grains, and legumes are packed with cancer-fighting phytochemicals.
Maintaining a healthy weight, avoiding alcohol, and exercising regularly decrease the risk of developing colorectal cancer.
Fiber — or the roughage that gives plant foods their bulk — helps fight colorectal cancer. One study found that those who consumed the most fiber had a 72% lower risk of developing colon polyps, which can be precursors to colorectal cancer, compared with those who consumed the least fiber. A high-fiber diet helps prevent intestinal damage and speeds up digestive transit.
“Research shows that for every 10 grams of fiber we eat each day, we can lower our colorectal cancer risk by up to 10%,” said Anna Herby, DHSc, RD, CDE, nutrition education specialist for the Physicians Committee. “Simple ways to get that in include eating a little over a cup of raspberries, 2 tablespoons of chia seeds, or two-thirds cup of black beans.
