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Colorectal cancer cases rising among younger adults in Canada and U.S.

Click to play video: '1 in 5 patients with colon cancer now between 20 to 50 years old, doctors say'
1 in 5 patients with colon cancer now between 20 to 50 years old, doctors say
March is colorectal cancer awareness month. As Katherine Ward reports, doctors are noticing more of their patients are younger than ever before, and addressing the disease head-on is the best defence – Mar 22, 2021

In a concerning trend, an increasing number of younger people are being diagnosed with colorectal cancer in Canada and the United States – even though overall cases and deaths have fallen in recent years.

New statistics from the American Cancer Society (ACS) released this week showed that one in five cases, or 20 per cent, were among Americans aged under 55 years in 2019. That’s almost double the rate of 11 per cent in 1995.

It’s a similar situation in Canada, where colorectal cancer is the fourth most commonly diagnosed cancer, according to the Canadian Cancer Society.

“The rates are reportedly increasing among adults younger than 50 in Canada and the U.S.,” Elizabeth Holmes, senior manager of health policy at the Canadian Cancer Society, told Global News Friday.

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“This is certainly something that the cancer surveillance community is monitoring.”

Unhealthy diet, physical inactivity, smoking and alcohol consumption increase the risks for this type of cancer, but family history is also a contributing factor, said Holmes.

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Colorectal cancer starts in the colon or rectum – which are part of the large intestine – and can also spread to other parts of the body.

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U.S. data also showed a rise in later-stage diagnosis, with 60 per cent of all new cases at the advanced stage in 2019 compared with 52 per cent in the mid-2000s.

“Despite continued overall declines, CRC (colorectal cancer) is rapidly shifting to diagnosis at a younger age, at a more advanced stage, and in the left colon/rectum,” the ACS said in its March 1 report.

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It’s not clear if the same trend of advanced-stage diagnosis is also being seen in Canada.

In Canada, it was estimated that 24,300 people would be diagnosed with colorectal cancer in 2022, with 9,400 deaths from the disease, the CCS website states.

Colorectal cancer symptoms and screening

Since the early 2000s, the incidence and death rates for colorectal cancer have been decreasing, likely due to a reduction in modifiable risk factors, improvements in screening and advancements in treatment, said Holmes.

Some of the symptoms of colorectal cancer to look out for include blood in the stool, unexplained weight loss, and a change in bowel habits like diarrhea or constipation, she said.

Canadian provinces have routine colorectal cancer screening programs that are recommended for people aged 50 to 74 years.

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An easy-to-use stool test called the fecal immunochemical test (FIT) can also be done at home, said Holmes.

“It can help find both colorectal cancer early, as well as precancerous conditions that might become colorectal cancer if left untreated,” she said.

Both Ontario and British Columbia recommend FIT screening every two years, while Albertans are eligible for annual FIT screening.

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Keys to detecting and preventing colorectal cancer

Besides regular screening, there are other ways to reduce the risk of colorectal cancer.

These include avoiding red and processed meat, limiting alcohol consumption, increasing physical activity and eating lots of vegetables, fruits and fibre, said Holmes.

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“About half of colorectal cancers can be prevented through healthy living and policies that protect the health of Canadians,” she added.

The ACS report showed that more people are surviving colorectal cancer, with the five-year survival rate rising to 65 per cent during the 2012-2018 period – up from 50 per cent in the mid-1970.

This is partly due to earlier detection through routine examinations and screening as well as advances in treatments, ACS said.

In Canada, the current five-year survival rate for colorectal cancer is about 67 per cent, said Holmes.

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