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The Changing Face of Colon Cancer

The Changing Face of Colon Cancer

Adults aged 50 and older have seen an impressive 32% drop in colorectal cancer and an even more impressive 52% decline in death rates over the past few decades. Unfortunately, colorectal cancer rates for those younger than 50 are moving in the opposite direction.

What's behind the significant improvement in older adults? According to the American Cancer Society, it's the increased number of people getting colonoscopies – a screening procedure that can detect and remove polyps. Approximately 30% of men and 25% of women over age 45 have precancerous polyps, so the benefits of a colonoscopy screening for all adults is abundantly clear. Even if the polyp contains cancer cells, no further treatment is usually needed if the cancer hasn't spread. That means a colonoscopy is much more than just a screening – it's actually a way to prevent cancer.

While there is lots of good news, there's also a very concerning trend to consider: colorectal cancer rates in younger people have been increasing every year since the mid-1990s. In fact, since 1994, the rate of colorectal cancer in adults younger than 50 has increased an alarming 51%. This clear trend is what led the US Preventive Services Task Force and the American Cancer Society to lower their recommended age for first-time colonoscopy from 50 to 45.

Current screening guidelines state that:

  • People at average risk for colorectal cancer should get their first colonoscopy screening at age 45. Depending on your results, you may be able to wait another 10 years before getting an additional screening.
  • Healthy people should continue colonoscopy screenings through age 75.
  • People over the age of 75 should talk to their doctor about the need and frequency for screening.
  • Adults at increased risk should talk to their doctor about more frequent screenings. Factors that increase risk include:
    • Personal history of colorectal cancer, ulcerative colitis, Crohn's disease, and certain types of polyps
    • Family history of colorectal cancer
    • Past radiation to the abdomen or pelvic area to treat a prior cancer

Another reason a colonoscopy is so important is because colon cancer rarely causes symptoms during the early stages – when it's most treatable. As it progresses, symptoms can vary depending on the cancer’s size and location, but may include:

  • A change in bowel habits, including diarrhea or constipation
  • A change in stool consistency that lasts longer than four weeks
  • Rectal bleeding or blood in your stool
  • Persistent abdominal cramps, gas or pain
  • A sense that your bowel doesn't empty completely
  • Weakness or fatigue
  • Unexplained weight loss

If you have experienced any of these symptoms – regardless of your age – talk to your doctor.

While getting a regular colonoscopy is the most important thing you can do to protect yourself from colon cancer, there are other lifestyle steps you can take to reduce your risk. No matter what your age, consider these guidelines for minimizing your risk of colorectal cancer as well as a host of other health issues:

  • Maintain a healthy body weight and exercise regularly. Obesity and a sedentary lifestyle increase your risk for colon and many other types of cancer.
  • Eat a healthy diet full of high-fiber food. Eat a variety of fruits and vegetables, especially raw. Get your protein from fat-free or low-fat dairy products, lean meats and poultry, eggs, nuts, seeds, soy products, whole grains, and legumes (beans and peas). Cook with oils low in saturated fats (olive, canola, flax seed, avocado, walnut, sesame, and grapeseed). Reduce your sugar and salt intake, and avoid processed foods.
  • Reduce consumption or completely eliminate red and processed meats. Meats that are red when raw (beef, pork, lamb) and processed meats such as bacon, sausage and cold cuts have been linked to colorectal cancer.
  • Don't smoke. Smoking has been linked to cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, and rectum, as well as acute myeloid leukemia.
  • Limit your alcohol consumption. The recommended maximum is one drink a day for women and two for men.

Learn more about colonoscopy screening at El Camino Health.


This article first appeared in the March 2023 edition of the HealthPerks newsletter.

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