Colorectal Cancer on the Rise

Good news: more people over the age of 50 are doing what the doctor has ordered and are being screened for colorectal cancer. Their diligence and improvements in screening technologies have contributed to a declining rate of new cancer diagnoses. Don’t get too excited, though, because that is not the whole story for those under 50 — a group which isn’t typically screened for the disease.

“Although young adults account for only a small portion of diagnosed colorectal cancers, the incidence of colorectal cancer in this age group unfortunately is increasing,” says Dr. Lilian Chen, Colon and Rectal Surgeon at Tufts Medical Center. Genetic predisposition and a family history of colorectal cancers are more often the cause of the disease in younger people. “I do not think this can entirely explain the trends we are seeing.”

“Development of colorectal cancer is a complex combination of genetic as well as environmental and behavior factors,” Dr. Chen continues. “One of the factors that have been proposed as a possible reason for the trends we are seeing is the rise in obesity, a known risk factor for development of colorectal cancer.” Besides obesity, other contributors include eating a poor diet (one that is high in processed foods and low in fiber) and not exercising. Dr. Chen suggests that it is important to identify those at a higher risk, which could influence screening recommendations for young people.

March is Colorectal Cancer Awareness month, and the medical team at Tufts is bringing attention to this deadly disease in several ways. Doctors in the cancer program will present lectures to the local community regarding colon cancer screening and awareness. The entire medical team of specialists in oncology, radiation oncology and pathology participate in clinical trials and research dedicated to finding causes and treatments for colorectal cancer. Our gastroenterology team is one of the key players, performing hundreds of colonoscopies which can detect and remove early-stage cancerous lesions. On March 9^th, Tufts Medical Center did a live tweet session of a colorectal cancer surgery. The surgeons removed a tumor found during a routine colon cancer screening.

Screening is an important way to detect colorectal cancer, and improvements in technology are being made every day. Ideally, screening is cost-effective and low risk. “Many colorectal screening options exist, each with its own risks and benefits,” Dr. Chen says.  “The most important thing for a patient would be to sit down with their doctor and discuss the various testing options. Colonoscopy is the only current option that allows us to not only detect cancerous lesions but also perform therapeutic removal of precancerous polyps. I highly recommend screening with colonoscopy.”  If further treatment is necessary, “Dr. [James] Yoo and I are trained in colorectal surgery and provide minimally invasive techniques for colon and rectal cancer resection. We even offer a combined endoscopic and laparoscopic surgery for removal of difficult lesions of the colon.”

Additionally, the Tufts Medical Center’s Reid R. Sacco Adolescent and Young Adult (AYA) Program for Cancer and Blood Diseases provides age-appropriate comprehensive care for young patients in the 18-39 age group with a history of cancer. “The program provides innovative support for patients’ current medical needs, coordination of specialty care and organization of long-term follow up.”

Dr. Chen advises parents that there are some things they can do to reduce their adolescent’s chances of developing colon cancer. She suggests

• Promoting a healthy lifestyle
• Maintaining a healthy weight
• Limiting the amount of red meat and processed foods in the diet
• Eating plenty of fruits and vegetables

“They should also try and encourage physical activity every day.  The same recommendations would apply to young adults, in addition to limiting alcohol intake and not smoking,” she says.

According to the National Cancer Institute, colorectal cancer is the the third most common type of cancer and second leading cause of cancer deaths in the United States. However, it is also one of the more preventable cancers. By following a healthy lifestyle and getting regular screenings, the numbers of new colorectal cancer diagnoses should continue to decline — even for those under 50.