The rate of colorectal cancer diagnosis in people under age 50 has doubled since the mid-1990s to 2020, according to the National Institutes of Health.
This is occurring even as the overall rate of colon cancer diagnoses over the past five years has decreased 46%, due in part to an increase in colonoscopies, which can prevent cancer from occurring through removal of precancerous polyps.
This earlier diagnosis is one reason it’s now recommended people start screening at age 45, instead of age 50. Those five years can be important, particularly since colorectal cancer in people under 50 appears to be more aggressive.
“It’s concerning because we don’t know why it’s happening,” said Heidi McKean, MD, Avera medical oncologist specializing in gastrointestinal and colorectal cancer.
Changing Colon Screening Guidelines
Over the years, experts in the field of oncology and gastroenterology noticed the following trends. According to the American Cancer Society: An increase of more than 10% of colorectal cancers in people ages 20 to 39.
- Colon cancer in people under age 50 is increasing about 2% every year.
- About one in five colorectal cancer diagnoses are now in people 54 and younger.
Changing the screening guideline to start at age 45 will help get people in sooner, but not everyone is taking advantage of it.
McKean explained one case of someone just under age 50 diagnosed with a stage 4 cancer that had already spread to another body part.
That’s a person who qualified for a colon screening and didn’t get one.
Typically, between ages 50 and 65 the cancer is slower growing, one reason that colonoscopies can happen every 10 years if no polyps are found. But in people who are under age 50, colon cancer tends to be more aggressive and found at more advanced stages, when it’s harder to treat.
“That’s our concern, is that we keep finding these patients that have really aggressive types of cancer,” she said. “Young patients are increasingly diagnosed with advanced stages of cancer that’s already spread to the lymph nodes or other body parts,” she said. The liver and lungs are common sites where colorectal cancer spreads.
People under age 45 who do not qualify for the recommended screening would need a referral from a doctor, if they are showing symptoms or have a strong family history. A screening wouldn’t be covered 100% by insurance but with coinsurance or co-pay. (Talk to your insurance company about your specific plan coverage.)
