March marks Colorectal Cancer Awareness Month – it’s a time to shed light on the importance of early detection and prevention of colon cancer. Colorectal cancers affect hundreds of thousands each year, and historically, the prevention focus has been on people 50 years or older. However, recent studies show the rate of colon cancer patients under 50 is growing.

Jeffrey Owsley, DO, at Intermountain Health’s Lutheran Medical Center, and Yevgeniy Arefiev, MD, a gastroenterologist with St. Vincent Regional Hospital, helped unpack the latest guidelines for colon cancer screening, and gave insight into the rising trend of diagnoses among younger adults.

“Colonoscopy is the gold standard as it not only detects cancer, but it also prevents cancer in the long run because the screening detects colon polyps, which can develop into cancer over time,” explained Dr. Arefiev. “This year, 153,000 Americans will be diagnosed with colon cancer, and unfortunately, 52,000 Americans will lose their battle to a preventable disease.” 

Standard colon cancer screening guidelines

Colon cancer doesn't discriminate based on age, but certain risk factors can increase your chances of developing this disease. According to standard guidelines, individuals aged 45 and older should undergo regular colon cancer screenings.

“I recommend screening at age 45, or ten years prior to a first degree relative that had a colon cancer diagnosis,” said Dr. Owsley. “Then follow-up depends on what they find at the time of colonoscopy.”

Understanding your personal risk factors is crucial. Factors such as family history of colon cancer, inflammatory bowel disease, unhealthy diet, obesity, smoking, and sedentary lifestyle can all contribute to an increased risk. Discuss your risk factors with your healthcare provider to determine the best screening plan for you.

Understanding the rising trend

Recent trends have shown a concerning rise in diagnoses among younger adults. The American Cancer Society estimated that since 2020, there’s been a 9 percent increase in colon cancer diagnoses in people under 50. Considering that colorectal cancer is the second most common cause of cancer death, these new statistics are a reason for alarm.

“It is true that we are seeing colon cancer at a younger age than we have historically, and it’s unclear why that is the case,” said Dr. Owsley. “It likely is multifactorial with environmental exposure, versus dietary, versus sporadic genetic mutations.”

Not only are more young people getting diagnosed with colon cancer, but their cases tend to be more advanced. One study suggested this is due to people under 50 waiting longer to seek medical attention for their symptoms.

Dr. Owsley pointed out that younger patients don’t think of screening. “Most patients still think that the recommended age for screening is 50,” he said. “Also, the idea of having a colonoscopy is not appealing to a lot of people, so they will put it off for that reason.”

This trend underscores the need for increased awareness and early detection efforts. Younger individuals face unique barriers when it comes to colon cancer screenings. These barriers can include a lack of awareness about screening, fear or discomfort associated with the procedure, and challenges in navigating the healthcare system.

“Younger patients often do not have cancer at the top of mind when things are wrong or they are not feeling well,” said Dr. Owsley. “So, it is not uncommon that they simply won't do screening or evaluation.”

Importance of early detection

Early detection is key to effectively treating colon cancer and improving outcomes. When caught early, colon cancer is highly treatable, with a five-year survival rate over 90 percent. Dr. Owsley added that there is a near 20 percent improvement in survival rate when colon cancer is localized, instead of a regional spread.

“With colon cancer, early detection can be the difference between needing chemotherapy or not, or needing only three months of chemotherapy versus six months,” said Dr. Owsley. “So not only from a survivability standpoint, but also from a quality of life standpoint, the earlier it is caught, the better it is for the patient.”

Regular screenings can help detect precancerous polyps or early-stage cancer before symptoms develop, allowing for prompt intervention and treatment.

We wrote last year about colon cancer warning signs, and while it may be tempting to brush it off, getting screened can save your life. Maybe it’s genetic history or an unknown symptom, it’s better to be safe than sorry. And while the colonoscopy is still the gold standard, you can ask your provider about starting with non-invasive stool-based tests.

For younger adults, it's important to be proactive about your health and advocate for early screening. Don't hesitate to discuss your risk factors and screening options with your healthcare provider. Remember, early detection saves lives.