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Published on July 11, 2017

What to know about colorectal cancer in young adults

The incidence of colon and rectal cancers has been rapidly declining in older adults over the past two to three decades, thanks to screening efforts. However, a recent report from the American Cancer Society shows an increase in colorectal cancer in adults, age 50 and younger.

Dr. Folkers

Trey Folkers, MD, Gundersen Gastroenterology

The report found that those born in 1990 have double the risk of colon cancer and quadruple the risk of rectal cancer compared to people born around 1950.

Gundersen Health System gastroenterologist Trey Folkers, MD, says the study underscores the need for increased awareness among clinicians and the general public.

"While it’s still pretty rare to have people in their 20s and 30s diagnosed with colorectal cancer, the research shows the incidence in younger adults is definitely on the rise. Rectal cancers appear to be rising much faster than cancers in other parts of the large intestine and colon," Dr. Folkers notes.

No one knows the exact cause, but there are dietary and lifestyle changes that young people can follow to lower their risk.

"I advise my patients that anything that is bad for the heart is bad for the colon," Dr. Folkers says. He recommends a high-fiber diet and less high-fat foods, including red and processed meats, and beer which has been associated with increased incidence of rectal cancer.

He also stresses the importance of screening. "We’re still only screening nationally about 40 percent of people who should be screened. Beginning at age 50, men and women should have a colonoscopy every 10 years. People with a family history of colorectal cancer, or who have inflammatory bowel disease, should have earlier and more frequent screenings," he says.

Colonoscopy remains the gold standard because it not only detects cancer but can identify polyps and remove them before they become cancer.

While there are currently no standard screening recommendations for adults under age 50, clinicians should pay attention to family history of colorectal cancer and/or polyps, and be aware of the warning signs:

  • Blood in the stool
  • Change in caliber or frequency of stools
  • Anemia
  • Unknown weight loss
  • Persistent abdominal discomfort

If a patient presents with blood in the stool, Dr. Folkers recommends taking a family history and doing a rectal exam. "You can palpate a tumor in the rectum. If no lumps or hemorrhoids are found on the exam, further evaluation would be needed," he says.

To make a referral or to ask questions about a patient in your care, contact Gastroenterology via MedLink at (800) 336-5465. In La Crosse, call (608) 775-5465.

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