Millennials, Gen Xers at Risk

"People born in 1990, like my son, have double the risk of colon cancer and quadruple the risk of rectal cancer [in comparison to someone born in 1950]."
"They [younger people] carry the risk forward with them as they age."
Rebecca Siegel, epidemiologist, American Cancer Society

"I wasn't really trying to lose weight, but I just didn't enjoy eating [as a 29-year-old colon cancer victim whose symptoms were loss of appetite, weight loss]."
"I definitely want to get the word out: If you have symptoms that may be linked to cancer, colorectal cancer or any kind, get it checked out."
Chris Roberts, colon cancer patient

ON THE RISE  For decades, colorectal cancer rates have been falling, but a new report finds an uptick in the rates among U.S. adults under 50. Here, an X-ray illustrates where a colon tumor (green) has constricted the large intestine. Biophoto Associates/Science Source

Thanks to the widespread screening that takes place with tests such as colonoscopies, colorectal cancer rates have declined substantially in the past years, with greater awareness due to information campaigns and physicians being alert for symptoms in their older patients. Screening by colonoscopy is recommended from age 50 onward. For African-Americans, screening is advised beginning at age 45, taking into consideration the higher risk among that community.

It was unthinkable to refer people in their 20s or 30s for screening, since those cancers were always known to strike older people. But just as the incidence of colon and rectal cancers have declined among the older population, for some mysterious reasons that researchers have been unable to identify, they have risen among younger populations. And, because this is still an emerging situation, when young people present with symptoms synonymous with those cancers, doctors diagnose other illnesses.

The American Cancer Society estimates that about 13,500 new cases of colon and rectal cancers will be seen to appear in the under-50 group in the United States this year. It is now recognized that rectal cancers are on a sharp rise in an younger age cohort, their incidence growing more swiftly than cancers that occur in other parts of the large intestine or colon. In the same time frame over 95,500 cases of colon cancer and close to 40,000 of rectal cancer in all age groups will be diagnosed.

Dr. Siegel, with the American Cancer Society is the lead author of a new report outlining these figures; her report recently published in the Journal of the National Cancer Institute. The risk of colon cancer among those born in 1990 was identified as five per million people of that birth group, a rise from three per million at the same age in 1950. As for rectal cancer, it has increased dramatically from 0.9 per million for those born in 1950 to four per million for those born in 1990.

What the medical community now realize is that because young people are not targeted for colon or rectal cancer as their older counterparts are, by the time their cancers are diagnosed they have all too often advanced to the point where their treatment may not succeed; some of the cancers so well established that treatment is no longer even feasible.

One young woman, at age 20, visited her doctor repeatedly with the complaint of blood in her stool. She was dismissed with the diagnosis of internal hemorrhoids, entirely because of her age, untypical for diagnosing cancer. Eventually the diagnosis of cancer was made, but by that point the colon cancer had advanced, at age 22. She underwent surgery and chemotherapy, and was pronounced free of cancer.

A 40-year-old woman, mother of four, experienced chronic constipation for years on end. Finally seeking medial help, she attended a clinic emergency room and a scan detected a tumour in her colon "the size of  a tennis ball". The cancer, however, had not yet spread. The young man quoted above, Chris Roberts, had moved to New York and was without a regular doctor's care. When he did find one and described his symptoms, including the loss of nine kilos, the doctor went right to work.

An ultrasound discovered that tumours had spread to his liver. Surgery followed to remove parts of his colon and liver, and then came chemotherapy. He is quick now to give advice to other young people who experience the tell-tale signs of cancer. And no one knows whether the trend for these cancers to strike young people will continue the upward trajectory.

Deaths from all cancers in 2014 were highest along the Mississippi River, near the Kentucky-
West Virginia border, Western Alaska and the South in general. Deaths were lowest in places like Utah and Colorado.