Colon and Rectal Cancers Increasing in Young People

Although the numbers of new colon and rectal cancers have been steadily declining in people over 50, the rate of newly diagnosed cancer is increasing in young adults from 20 to 49  in the United States.

The increase is primarily driven by rectal cancer in non-Hispanic whites where there was an average annual increase of 3.5 percent in men and 2.9 percent in women from 1992 through 2005.  Overall, incidence of colorectal cancer in young adults rose during that time 1.5 percent in men and 1.6 percent in women each year, almost all of the new cancers diagnosed in the left colon (distal colon) or rectum.

Information about increasing rates of colon and rectal cancer were obtained by studying  data from 13 Surveillance, Epidemiology, and End Results cancer registries from 1992 through 2006.  Researchers analyzed information by sex, race and ethnicity, age, site of cancer, and stage at diagnosis.

In attempting to find a reason for increasing colorectal cancer rates in the younger group, who are not part of screening programs, the researchers looked at risk factors for colorectal cancer.  Obesity is a major risk factor for colorectal cancer, and it is increasing in all age groups in the United States, as is Type 2 diabetes, which also increases chances for colon and rectal cancer.

Eating red meat increases colorectal cancer risk in the left colon and rectum, while consumption of calcium-rich foods decreases risk.  Young adults’ consumption of fast food increased three-fold between the late 1970’s and the mid 1990’s.  During that time calories from hamburgers and cheeseburgers increased by 30 percent while milk consumption  went down by 42 percent.  Young adults are eating more red meat, more calories, and less calcium-rich foods.

Two other risk factors, alcohol use and smoking, have been declining in young adults.

The study authors point out young people who may have inherited a gene for colon cancer or have inflammatory bowel disease should begin screening earlier than age 50 and that physicians need to know and follow the guidelines.

Clinical practice guidelines suggest that patients with inflammatory bowel disease, polyposis syndromes,a known genetic predisposition, or a personal or family history of adenomatous polyps or CRC begin screening before age 50 years. Early recognition of CRC in patients under age 50 without these risk factors requires clinical awareness and aggressive pursuit of symptoms.

Almost 9 out of 10 young adults had symptoms of colon or rectal cancer at the time of diagnosis.  Half had rectal bleeding and a third had abdominal pain.  Among those without symptoms, 14 percent had anemia.

Our findings of a recent increase in CRC among those under age 50 years suggests the importance of timely evaluation of the distal colorectum, at a minimum, in young adults who present with symptoms consistent with possible underlying cancer.

In conclusion, Rebecca L. Siegel and her team at the American Cancer Society wrote,

The increasing incidence of CRC in young adults is in contrast with the rapidly declining incidence among older individuals. The disparate increase in left-sided CRC suggests that particular attention be given to studies to elucidate the behavioral and environmental risk factors responsible for this trend and potential prevention and early detection strategies.

SOURCE: Siegel et al., Cancer Epidemiology, Biomarkers, and Prevention, Volume 18, Number 6, June 2009.


  1. Kate Murphy says

    The FDA regulates colon hydrotherapy devices and permits their use only by licensed physicians in preparation for medical procedures like colonoscopy.

    • FDA has warned a number of non-medical colon hydrotherapy providers to stop advertising or providing unlicensed use of equipment that pumps water into the colon, often under pressure.
    • Lawsuits in Texas and other states have been successful in stopping the sale of such equipment and in favor of patients who were harmed during hydrotherapy, including having their colons perforated

    Potential harms from hydrotherapy include:

    • Cases of perforated colons from hydrotherapy — a very serious situation that risks infection within the abdominal cavity and may lead to death.
    • Removing healthy bacteria from the colon, allowing dangerous bacteria to flourish.
    • Infections spread from patient to patient from poorly sterilized or dirty equipment.
    • Amboebic infections reported after hydrotherapy.
    • Allergic or other reactions to chemicals, herbs, or other substances added to hydrotherapy water.
    • Cramping, abdominal pain, and bleeding during or after the procedure.

    People who are experiencing frequent constipation — hard stools that are painful to pass or bowel movements that occur less than every three days — should talk to their doctors about finding the cause and best treatment. The American Gastroenterological Association has information for patients about constipation.

    Outside of approved clinical trials, C3 recommends the use of drugs and medical devices that are regulated by the United States Food and Drug Administration and have proven safety and effectiveness. C3 Patient Information on Complementary and Alternative Medicine

  2. Kate Murphy says

    Although colon cleansing is widely advertised, there is no scientific evidence that it is effective in treating or preventing any disease. It is illegal to make such claims in the United States without FDA approval of the drug or medical device.

    There is also no evidence of toxins building up in the colon. Toxins from food and medicine taken orally are removed via the liver and kidneys. Bacteria, such as e.coli, that form toxins within the intestinal tract cause diarrhea and vomiting to speed their removal.

    While almost all absorption of nutrients from food during digestion takes place in the small intestine, water is removed from remaining undigestible food in the large intestine or colon and undigested contents or feces moved ahead to be stored in the rectum until emptied by a voluntary bowel movement.

    There is no evidence from pathologists or gastroenterologists that feces build up on the walls of the colon. In fact, dying cells from the colon wall are renewed regularly every few days, shed into the colon, and excreted during bowel movements.

    Advertised “colon cleansing” falls into two categories: dietary supplements and colon hydrotherapy.

    Dietary supplements sold as colon cleansers may contain fiber or herbs or other substances that act as stimulant laxatives. The fiber increases content in the large intestine and laxatives stimulate the muscles of the intestine to move that content forward. Some substances also pull water into the colon to produce loose stools.

    The Food and Drug Administration (FDA) prohibits marketing any dietary supplement that claims to prevent or treat any disease, so colon cleansers taken by mouth cannot advertise that they do so without proving their safety and effectiveness. Consumer testimonials that they felt better or less tired or got sick less often are not good enough proof —
    and other consumers need to know that.

    Advertisements that show large amounts of fecal material after taking colon cleansing dietary supplements probably reflect the undigestible fiber in the supplement — not materials that “stuck” to the colon wall.

    Potential safety issues for dietary supplements sold as colon cleansers include dehydration if laxatives cause diarrhea and water loss, damage to healthy bacteria in the colon, or adverse reactions to the ingredients in the supplements. They may also cause cramping, abdominal pain, nausea, or vomiting.

  3. says

    Your overall health depends in large part on the health of your colon. This is because all of the food you eat is processed in the colon. In due time, however, harmful toxins that are normally discarded during bowel movement builds up in our colon and these can cause health problems such as constipation, weight gain and reduced energy levels. For this reason, it is very important to do a colon cleanse.

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