Tag Archive for: early onset colorectal cancer

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Common Early Warning Signs for Colorectal Cancer in Young Adults 

Often, colorectal cancer (CRC) doesn’t cause symptoms until it grows or spreads. It is often harder to detect in the younger population who might ignore symptoms due to lack of insurance coverage, and because they are not yet eligible for screening because of their younger age. However, findings from a recent study might provide some clues to identifying the early onset of CRC among young adults not old enough to qualify for CRC screening. 

Those under 45 may not have insurance coverage for any form of CRC screening—colonoscopy, FIT, or FOBT—because the recommended age to start screening for CRC is 45 years. According to the American Cancer Society, 2,001,140 new cases of cancer are projected in the U.S. in 2024,152, 810 of which may be CRC. Another concerning statistic is the 2% rise in the annual CRC incidence rate among young adults (ages <55 years). 

Paying Attention to The Early Signs

The study identified 4 red-flag signs and symptoms occurring at least three months before diagnosis that were associated with a subsequent risk of early-onset CRC:

  • Abdominal pain 
  • Rectal bleeding 
  • Diarrhea
  • Iron deficiency anemia 

A total of 5,075 early-onset CRC cases and 22,378 controls were included in the study. 63% of the cases were diagnosed with CRC. The authors found that in the study population:

  • Abdominal pain and rectal bleeding were the most common symptoms
  • Abdominal pain was associated with a 34% higher risk of early-onset CRC 
  • Signs of rectal bleeding had the greatest association with developing CRC 

Diarrhea and iron deficiency anemia were also identified as a common symptom but did not have a high association with CRC.

Having one, two, or three of these warning signs and symptoms were linked to a 1.9-, 3.6-, and 6.5-fold higher risk of developing CRC, respectively. These correlations were stronger for rectal cancer and young-onset cases (average 43 years).

Despite the possibility that this study helped focus on the early warning signs and symptoms of CRC, it is crucial to remember that the signs and symptoms described above can also be the result of other health conditions such as inflammatory bowel disease, hemorrhoids, irritable bowel syndrome, or infections. In order to properly identify and treat the condition, it is important to see a doctor and get screened if you are experiencing any of those symptoms.

 

Emmanuel Olaniyan is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Picture credit: Muhammad Daudy on Unsplash

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Colorectal Cancer: New Data Suggest Rising Rates, More Advanced Disease in Young Adults 

On March 1, 2023, the first day of Colorectal Cancer Awareness Month, the American Cancer Society released some alarming new statistics regarding early-onset colorectal cancer (CRC) diagnoses: in the U.S. population, people are increasingly being diagnosed with CRC at a younger age and with more advanced disease stage. Advanced-stage CRC diagnoses have risen by eight percent in the past two decades. Additionally, early onset diagnoses rose from one in ten individuals in 1995 to one in five in 2019. While CRC in the general population is declining, rates in younger people are on the rise. 

The complete report contains CRC incidence, mortality, and screening prevalence data that were derived from multiple national databases, including: 

  • National Cancer Institute
    • Surveillance, Epidemiology, and End Results (SEER) program
  • Center for Disease Control
    • National Program of Cancer Registries
    • Behavioral Risk Factor Surveillance System
    • National Center for Health Statistics
      • National Health Interview Survey
  • North American Association of Central Cancer Registries

The report projects that of the 153,020 expected CRC cases in 2023, 13% (nearly 20,000) will be in individuals younger than 50. Seven percent of projected CRC mortality will also be in individuals younger than 50. CRC mortality in individuals under the age of 50 is also on the rise, as the mortality rate in this population has risen one percent every year since 2004. 

Rising cancer trends in the younger U.S. population point to increased exposures to causal agents, and indicate the need for research that identifies newfound risk factors. The data from this report highlights the growing concern that is early-onset CRC incidence and mortality, pointing to a portion of the population that will need more research and funding in the CRC space. 

Efforts to improve screening rates at a health care center in New York City

Racial Disparity in CRC Incidence and Mortality

Racial disparities continue to exist in CRC incidence, mortality, and survival rates. Both incidence and mortality rates in the U.S. are highest among American Indian/Alaskan Native and non-Hispanic Black individuals. Alaskan Native individuals face the highest burden of CRC incidence than any other group (88.5 per 100,000 individuals). Risk factors that contribute to disparities in the Alaskan Native population are likely a combination of environmental factors (low sun exposure, diet low in fiber, smoking, and obesity) and low access to colon health care services. Alaskan Native individuals have the lowest screening rate in the U.S. 

Black Americans are more likely to be diagnosed with metastatic CRC than any other racial or ethnic group in the nation. Black patients also experience significant disparities in care, and are 21% less likely to receive colon cancer surgery and 28% less likely to receive rectal cancer surgery. Additionally, Black patients are more likely to develop right-sided tumors, which are correlated with a poorer prognosis. 

These updated data from the American Cancer Society point to the need for future research in early-onset incidence, racial disparities, and general risk factors for CRC. Scientists should aim to identify newfound risk factors that are contributing to the trend of CRC diagnoses under 50, and to identify factors specific to high-risk racial and ethnic groups as well.

You can learn more about the signs and symptoms of colorectal cancer on this page.

 

Emma Edwards is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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Medicaid Expansion May Have Improved Diagnosis of Early-Stage CRC

Health insurance coverage is an important determinant of access to health care. Most people in the U.S. receive health insurance through their employers and many others qualify for government insurance programs like Medicare (generally for those >65 years) or Medicaid (for low-income families/individuals). The 2010 Affordable Care Act mandated preventive screening coverage for those who are enrolled in Medicaid and provided support to participating states. A cross-sectional cohort study has now revealed that after Medicaid expansion in 2014, the proportion of patients diagnosed and treated at Commission on Cancer–accredited facilities increased within expansion states and decreased in non-expansion states. 

This study evaluated whether the proportion of patients diagnosed with early-stage colorectal cancer (CRC) changed over time within states that expanded Medicaid, compared with non-expansion states. The authors queried the multicenter registry data from the National Cancer Database (2006-2016) and identified a total of 10,289 patients in expansion states and 15,173 patients in non-expansion states. They found:

  • A 0.9% annual increase in the number of individuals diagnosed with early-stage CRC in expansion states after 2014 
  • A 0.8% annual reduction in the number of individuals diagnosed with with early-stage CRC in non-expansion states after 2014 
  • By 2016, the absolute difference in the propensity-adjusted proportion of early-stage CRC was 8.8% 

Similarly, a study published in the Journal of American Surgeons also found that Medicaid expansion has had a notable impact on the diagnoses of early-stage CRC compared to non-expansion states. 

Improved insurance coverage following Medicaid expansion may have facilitated access to screenings and earlier diagnoses. 

For more information on insurance coverage for CRC screening, please visit: Insurance Coverage for Colorectal Cancer Screening. 

 

Kitty Chiu is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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