This week the Journal of the American Medical Association (JAMA) Surgery released results of a study: Increasing Disparities in the Age-Related Incidences of Colon and Rectal Cancers in the United States, 1975-2010. According to JAMA Surgery, the study indicates there may be an increase in colorectal cancer diagnosis among people younger than age 50 on the horizon based on current trends.

The study results may substantiate the previously observed concern about the increased number of young people being diagnosed with colorectal cancer (CRC). "Young people" refers to those under age 50 - the recommended age to begin screening for CRC for patients of average risk.

No Duh.

The advocacy and support community have been hearing the concern and interest in examining the number of young people diagnosed with CRC for some time. This is an issue that Fight Colorectal Cancer takes extremely seriously. We are actively engaged and partnering with a number of coalitions and campaigns to help raise awareness about the growing number of colorectal cancer cases in young people. Team members from Fight Colorectal Cancer, Danielle Burgess and myself (Andi Dwyer), are currently chairing two committees of the Never Too Young Coalition, a taskforce of colorectal cancer organizations built to conduct research on the rise of young colorectal cancer patients and to educate the nation on this growing trend. For the first time in 2015, we plan to fund a late-stage research grant through our Lisa Fund in partnership with Michael's Mission that   specifically evaluates better treatment options for late stage colorectal cancer in patients younger than age 50.

What We've Known for Awhile

Data from 2013 showed us there were an estimated 142,820 new cases (incidence) of colorectal cancer diagnosed with an estimated 50,830 deaths in the United States. While the incidence of colorectal cancer in people 50 years or older has declined, people ages 20 to 49 have seen an increase in cases. This drop in colorectal cancer diagnosis for those age 50+ is likely attributed to an increase in screening. However, the demographic where CRC cases are increasing applies to those whose ages fall outside of the current screening guidelines.

The only way to help prevent CRC in young adults is to educate them about the signs and symptoms and how to know their bodies. They need to be their own advocates so they are not diagnosed at later stages.  Also, we need to educate the medical community to diagnose  young adults according to their symptoms, not their ages." -  Krista Waller, president of The Colon Club, a nonprofit organization raising awareness of CRC patients under age 50

What Did This New Study Shed Light On?

First - The Data

This week's JAMA Surgery article validated the concern of the community and the stories of many of our advocates. Christina E. Bailey, M.D., M.S.C.I., of the University of Texas MD Anderson Cancer Center, Houston, and her co-authors analyzed trends in CRC incidence in the U.S. based on age groupings. Using a national CRC registry database of 393,241 patients (SEER data), the study indicated that:

• Incidence for patients 50 and over saw a decrease in new colorectal cancer diagnosis, this drop was the biggest in those 75 years or older.
• Incidence rates for patients 20 to 49 increased, with the biggest increase of in patients 20 to 34 years old. Many of these cancers are diagnosed at late stage.

Researchers projected incidence rates for colon, rectal and sigmoid cancer in 2020 and 2030. The data suggests alarmingly increased rates in young people but decreases in incidence in people 50 and older. Projections Based on Data from Study Results

	2020	2030
Colorectal Cancer in People 20-34	Increase by 37.8%	Increase by 90%
Rectal and Sigmoid in People 20-34	Increase by 49.7%	Increase by 124.2%
Colorectal Cancer in People Older 50	Decrease by 23.2%	Decrease by 41.1%
Rectal and Sigmoid in People Older 50	Decrease by 23.2%	Decrease by 41.0%

The results of the study based on examination by age is staggering and might have real implications for screening and health recommendations going forward.

Second- The Hopeful Future of Research

This study will likely spur more interest and examination; however, this will need further analysis before making larger clinical or public health changes. It's important for patients to continue sharing their stories and pushing for change.

Although the predictions of future cases in this new JAMA Surgery study are daunting and somewhat depressing, a silver lining is that there is finally significant attention being given to the "under 50" problem in colorectal cancer. This is something I've not seen in my 14-years of survivorship. Hopefully we can prove the predictions wrong with more advocacy, research and a desire to change the status quo on screening. We want to prevent future cases of CRC in ALL demographics - including those under age 50. - Danielle Ripley-Burgess, 2x survivor diagnosed at ages 17 and 25, Director of Communications for Fight Colorectal Cancer

Moving Forward for Young CRC Patients

Fight Colorectal Cancer will continue to advocate for all colorectal cancer patients. We cannot ignore the data that CRC is impacting young people. Our future plans will fund research focused on "under 50," and keep us active in coalitions. We also have resources currently available for any patients facing late-stage disease (check out the Guide in the Fight). We're committed to our goal:  victory over colorectal cancer. And that includes those under age 50.

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