Colorectal cancer is showing up in younger people and at more advanced stages: study

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Advanced stage colorectal cancer (CRC) cases are on the rise and the disease is being discovered among younger patients more frequently, according to Colorectal Cancer Statistics 2023, a new report on cancer facts and trends by the American Cancer Society (ACS), which is headquartered in Atlanta. 

Although deaths related to CRC are continuing to decline, the report indicated the disturbing trend within the landscape of fighting this disease.

Notably, this includes the advanced stage of cancer at the time of diagnosis and the patient’s age at which it's diagnosed. 

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The incidence of advanced stage CRC disease now occurs in three out of five people, while one out of every five CRC diagnoses are made in people under 55 years old, according to the study's investigators.

Also, people who are natives of Alaska had the highest rate and mortality — almost four times higher than those of non‐Hispanic White individuals, according to the report.

A new study has found that the incidence of advanced stage CRC disease now occurs in three out of five people — and one out of every five CRC diagnoses are made in people under 55 years old.  (iStock)

It was published on Wednesday, March 1, in the journal CA: A Cancer Journal for Clinicians and in the publication Colorectal Cancer Facts & Figures 2023-2025 on cancer.org. 

"We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population," Rebecca Siegel, senior scientific director, surveillance research at the American Cancer Society and lead author of the report said in a news release. 

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"The trend toward more advanced disease in people of all ages is also surprising and should motivate everyone 45 and older to get screened," Siegel said in the release as well. 

"The trend toward more advanced disease in people of all ages is also surprising and should motivate everyone 45 and older to get screened."

The researchers collected data from 50 states and the District of Columbia. 

The data was available through 2019 from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute and the National Program of Cancer Registries of the Centers for Disease Control and Prevention, as provided by the North American Association of Central Cancer Registries. 

Despite overall declines in mortality from the disease, doctors are seeing a diagnosis of CRC more frequently in those of a younger age — and at a more advanced stage of illness. (iStock)

The researchers also looked at national mortality data available through 2020 that was provided by the National Center for Health Statistics, according to the report. 

Overall, CRC mortality declined by 2% annually from 2011 to 2020, yet there was an 0.5%–3% annual increase in mortality in individuals younger than 50 years old and in Native Americans under 65 years of age, according to the study. 

Despite these overall declines, a diagnosis of CRC is being seen more frequently in those of a younger age and at a more advanced stage.

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The investigators noted that individuals in the U.S. diagnosed with advanced-stage colorectal cancer increased from 52% in the mid-2000s to 60% in 2019.  

"We have to address why the rates in young adults continue to trend in the wrong direction."

The number of CRC cases in individuals under 55 years old nearly doubled from 11% in 1995 to 20% in 2019. 

That is a jump from 1 in 10 people to 1 in 5, according to the release.

"We have to address why the rates in young adults continue to trend in the wrong direction," Dr. Ahmedin Jemal, senior vice president, surveillance and health equity science at the American Cancer Society and senior author of the study, said in a news release. 

"We need to invest more in research to uncover the causes of the rising trends and to discover new treatment for advanced-stage diseases to reduce the morbidity and mortality associated with this disease in this young population, who are raising families and supporting other family members." 

Colorectal Cancer Awareness Month is observed in March to stress the importance of screening for this form of cancer.

‘Highly concerning data’

The researchers said an estimated 153,020 people will be diagnosed with CRC in the U.S., and that some 52,550 people will die from the disease in 2023. 

"These highly concerning data illustrate the urgent need to invest in targeted cancer research studies dedicated to understanding and preventing early-onset colorectal cancer," Dr. Karen E. Knudsen, CEO of the American Cancer Society, said in a news release. 

Cancer experts said they're concerned the diagnoses being made are for more advanced disease stages, in which the cancer has spread to lymph nodes and other organs, and among younger people.   (iStock)

"The shift to diagnosis of more advanced disease also underscores the importance of screening and early detection, which saves lives."

The report revealed that CRC cases declined rapidly in people 50 and older during the 2000s. This was attributed to increased screening with colonoscopy, which experts say can help prevent cancer by removing precancerous growths or polyps. 

The study authors found, however, that progress has slowed over the past decade, which could be in part due to the trend in rising cases in younger individuals, the study noted. 

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The report found that the 65 and older age group showed a decline in incidence rates since 2011 and that those rates stabilized in the 50-64 year old cohort. 

However, a disturbing trend showed an increased incidence rate by 2% per year in people younger than 50 years of age, as well as in people ages 50 to 54 years old. 

Colonoscopies were typically recommended at age 50, but in recent years, that number was changed to age 45 in average-risk individuals and earlier if there was family history or other risk factors. 

Cancer experts said they're concerned that the diagnoses being made are for more advanced disease stages, in which the cancer has spread to lymph nodes and other organs. 

When it comes to preventing colorectal cancer, "one of the simplest tools to tell people is to get a colonoscopy when they're young," Dr. Paul Oberstein, M.D., a medical oncologist at NYU Langone Perlmutter Cancer Center in New York City, told Fox News Digital. 

Oberstein was not involved in the study but commented on the findings. 

Colorectal cancer is the third most commonly diagnosed cancer and the third leading cause of cancer deaths in both men and women in the U.S., according to the study.  (iStock)

Colonoscopies were typically recommended at age 50, he said, but in recent years, that number was changed to age 45 in average-risk individuals and earlier if there was family history or other risk factors. 

While colonoscopies are the main standard used to diagnose CRC, new ways to screen for this type of cancer are needed, said Oberstein, especially based on these findings of more aggressive forms diagnosed in a younger population. 

"We don't actually know why rectal cancer is increasing in younger people," he told Fox News Digital.

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He added, "There are a lot of hypotheses. People think it might have to do with diet, or with antibiotics, or with exposure to other foods, [such as] processed foods — or you can make a list of anything. We don't know the answer. And so the challenge is that until we know that answer, it's really hard to turn it around if you don't know what we're targeting."

In addition to obtaining a colonoscopy, patients should be aware of signs of CRC. 

They should speak to their health care provider, he said, especially if they see blood in their stool or have intestinal issues that don't resolve.

CRC is the third most commonly diagnosed cancer and the third leading cause of cancer deaths in both men and women in the U.S., according to the study. 

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The American Cancer Society Cancer Action Network (ACS CAN) is continuing to advocate for the implementing of policies in each state to help cover the cost of colonoscopies and eliminate barriers to colorectal cancer screening.