The untimely deaths of actors Chadwick Boseman and James Van Der Beek, who both succumbed to colorectal cancer in their 40s, have heightened awareness of this disease, which is increasingly affecting younger individuals each year. Colorectal cancer, encompassing colon and rectal cancers, is now the leading cause of cancer deaths in adults under 50. New research reveals that rectal cancer deaths, specifically, are on the rise among this age group, particularly millennials. According to NBC, if current trends persist, rectal cancer could become the top cause of cancer deaths in people under 50 by 2035.
Understanding Rectal Cancer
While rectal cancer shares similarities with colon cancer, the key difference lies in the location. "The rectum is considered a part of the colon ... it is the end of the colon before the anus," explains Dr. Jatin Roper, a gastroenterologist with Duke Health and associate professor at Duke University School of Medicine. "Because the tissue is biologically fairly similar, rectal cancer is often categorized with colon cancer under the name of 'colorectal cancer.'" Dr. Michael Foote, a gastrointestinal medical oncologist at Memorial Sloan Kettering Cancer Center, adds, "Rectal cancers are tumors that start in the rectum. They're similar to colon tumors in many ways."
Warning Signs of Rectal Cancer
The most common symptoms include rectal bleeding and abdominal pain. "Rectal bleeding is much more common in younger people with rectal cancer," Foote notes. This may present as blood in the stool, maroon-colored stools, or blood on toilet paper. Abdominal pain is also frequently reported. Additional symptoms include changes in bowel habits, constipation, thinner stools, fatigue, weight loss, and anemia. "Any change in your gastrointestinal tract should not be ignored," Roper emphasizes. However, some individuals may have no symptoms, underscoring the importance of regular screenings.
Rising Rates in Younger Adults
Recent research from the American Cancer Society shows that while colorectal cancer rates are declining in adults 65 and older, they are increasing in younger adults. "The rate of rectal cancer is rising more quickly than the rate of colon cancer," Roper states. Since 1988, colorectal cancer rates in adults under 50 have increased by 63%, from 8 to 13 per 100,000. "Even in teenagers, the rate of rise is remarkable," Roper adds. Experts suspect environmental or dietary factors, such as Western diets high in animal fat, processed foods, and microplastics, as well as changes in gut microbiome, may contribute.
Risk Factors and Prevention
Obesity and diabetes are risk factors, but most younger patients do not have these conditions. To reduce risk, experts recommend routine screenings starting at age 45 for average-risk individuals, including colonoscopy or stool-based tests like Cologuard or FIT. Those with a family history may need earlier screening. A Mediterranean diet low in red meat and high in fiber, avoiding sugary drinks, limiting alcohol, and reducing plastic container use may help. Managing obesity and diabetes, establishing care with a primary doctor, and not ignoring symptoms are crucial. "If you're having symptoms, don't just sit on them," Foote advises.
