Rising colorectal cancer rates in younger adults prompt new awareness push

[0:00] If you're under the age of 50, it's likely that colorectal cancer isn't on your radar, [0:05] but it should be. Once considered an older age disease, [0:09] rates are skyrocketing among young adults. Dima Zain has more. [0:14] This year, an estimated 108,000 people in the U.S. will be diagnosed with colon cancer. [0:20] That's according to the American Cancer Society. And one in five are young, under the age of 55. [0:26] I spoke with two people who were diagnosed at an early age. Here's some of what they told us. [0:32] My name is Chrissy Garrett. I am from Long Island. I am currently 34 years old. [0:38] I was originally diagnosed with stage 3C colon cancer, and I am currently stage 4, [0:46] young onset sporadic MSI colon cancer. And I am currently still in treatment three years later. [0:55] My name is Sinti Asasin. [0:57] I was... [0:57] Diagnosed at the age of 26 in 2020, and I was diagnosed with colon cancer stage 3B. [1:06] I think I was just in complete shock, because having no family history of cancer ever, [1:13] never expected it. The past month and a half, I have been in and out of the hospital [1:18] with different reasons, because the tumors have been causing pain in my back. They've been causing [1:26] pain in my ribs. I've had... [1:29] Allergic reaction to the medications. And chemotherapy is not easy. [1:35] I never thought that I would have cancer because I was, like, just young, 26 years old, you know. [1:40] And it was heartbreaking. Throughout the time when I started my treatment, I think that my health [1:46] started going down, you know. That part was one of the hardest, because I was the breadwinner of the [1:51] house, you know, and not being able to go out and work, and not being able to provide for my family, [1:58] and somebody... [1:59] my wife have to take care of me my life has been stripped from me chemotherapy has stripped my life [2:06] and it's been very tough mentally physically and all the way around the first time i got [2:14] my bleeding i should have gone to colonoscopy because i ignored that i got my bleed i started [2:22] bleeding seven months prior to i got diagnosis you know when i went to my doctor i should have [2:27] asked for a colonoscopy they thought that it was just an ulcer this is not okay in your 30s [2:34] your 40s in your 20s you're just starting off your life you're just starting i mean i'm a [2:39] single homeowner i just started my career nine years ago it's this is not something you plan [2:45] for you have these big dreams of having a family getting married buying a house you don't factor [2:51] in cancer joining us to discuss this further is dr robin mendelson a gastroenterologist at memorial [2:57] Sloan Kettering Cancer Center and co-director of the Center for Young Onset Colorectal and [3:02] Gastrointestinal Cancers. Dr. Mendelsohn, thank you so much for joining us today. [3:07] Thank you for having me. [3:08] Can you give us a sense of how much colorectal cancer is rising in young patients today? [3:13] We've actually been seeing it since the 1990s, and it's been increasing by about 3% per year. [3:20] As we heard from those two patients, the majority of these patients don't have a family history. [3:29] We used to think, oh, you're young and you have colon cancer, has to be a genetic component, [3:36] there has to be about a family history. But only about 10% to 20% will have a family history [3:42] or a genetic predisposition. So the majority are what we call sporadic, [3:47] so with no known risk factors. [3:50] We are actively trying to figure out why this is happening. [3:55] And so when we're talking about this, who is most at risk then? [3:58] And what are the symptoms that people need to be watching out for? [4:02] Yep. So even though the numbers are increasing, the majority of people with these symptoms will [4:08] not have cancer. But as we heard, the number one symptom is rectal bleeding. [4:16] And we say any rectal bleeding that's persistent, [4:19] so anything more than a couple of weeks should definitely get checked out. [4:24] Again, the majority of people with rectal bleeding will not have cancer, [4:28] but should definitely be evaluated. Other symptoms are abdominal pain or distension, [4:35] that's new and not going away. Changes in bowel habits. So anybody that's had normal bowel habits [4:43] and is suddenly constipated or has been constipated their whole life and now has diarrhea. [4:48] Unexplained weight loss, so losing weight without meaning to. [4:54] And if you're found to be anemic on your blood work, so if your hemoglobin or your blood count [4:59] is low, sometimes that can mean that the cancer is shedding blood into the stool, [5:05] and that's why your blood count can be low. [5:07] And both of the patients that we spoke to had more aggressive stages when they were diagnosed. [5:12] Are we seeing people, especially these young people, being diagnosed at these later, [5:16] more aggressive stages? And if so, why? [5:18] Yes, we are. So the majority of these younger patients will present at later stages, [5:23] at stage three or four, and that's because they're presenting with symptoms. [5:28] So when it's early stage, stage one, there's usually no symptoms, and that's when we usually [5:34] pick it up on screening. So when our people who are in our screening age group, which is 45 or [5:41] older, when we do find cancer on screening, because they don't have symptoms, the majority [5:46] are found at early stages where it is. [5:48] Very, very treatable and curable. Unfortunately, once symptoms develop, [5:54] that usually indicates that it's a later stage. [5:58] And I know you mentioned there's not one factor that we're finding to cause this colorectal cancer [6:03] in young patients, but is there something that people can do to protect themselves to lower [6:07] the risk factor? [6:09] Yeah, so the traditional risk factors of colorectal cancer in average onset, so over 45, [6:16] also hold true for the younger groups. [6:19] So obesity, obesity is associated with colorectal cancer. And when you look at younger patients, [6:27] there are some patients that are obese. When we look back at our patients at Memorial Sloan-Kettering, [6:33] they were more likely to be overweight and obese, but when we compared them to a national [6:38] cohort without cancer, they were actually less likely to be overweight and obese. [6:42] So even though obesity is a risk factor, it's definitely not the entire answer, [6:47] but trying to maintain a normal, [6:49] um, body mass index is helpful. [6:52] Um, it's also associated with diets that are high in red meats and processed meats. [6:58] Again, many of these patients that we speak to do not eat red meat or processed meats. [7:03] They're vegetarian or even vegan, um, and adhere to what they consider a healthy lifestyle. [7:09] But in general, avoiding red meats and processed meats, sticking to a diet that is high in fruits [7:15] and vegetables, also increasing physical activity. [7:19] And avoiding alcohol and tobacco. [7:21] And if someone is unfortunately diagnosed with colon cancer, what steps should be taken and [7:27] how critical is it to catch it early? [7:30] So the earlier you catch it, the more treatable and beatable. [7:34] But even at later stages, we do have options, so it's important that when diagnosed to go [7:39] to a center, that's high volume and is seeing um, these patients, there's different treatments [7:45] based on the pathology, what it looks like under the microscope. [7:49] Um, [7:49] treatments depending on where it is in the colon so if it's the majority of our [7:54] younger patients are presenting with cancers that are lower down in the colon [7:59] and what we call the left colon or the rectum and those might be those are [8:02] treated differently sometimes than those that are at the top of the colon so it [8:06] really depends on where it is in your colon how much is involved what the [8:10] options are but there are options for all stages but the earlier that it's [8:14] caught the better the outcomes thank you so much dr. Robin Mendelson appreciate [8:19] your time thank you for more on this topic tune in to next weekend's episode [8:25] of horizons when William Brangham will take a closer look at rising rates of [8:29] multiple types of cancer in young people and what can be done to prevent it [8:33] support journalism you trust support PBS news donate now or even better start a [8:41] monthly contribution today