Colon cancer is killing young people more than ever: What to know about the first signs of the disease

An American Cancer Society report indicates colorectal cancer is the leading cause of cancer death in men and second in women under age 50.

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Colorectal cancer is the third leading cause of cancer deaths amongst men and women. (Photo via Getty Images) close up asian male doctor is holding blue ribbon on hands to disseminate colorectal cancer prevention and control
Colorectal cancer is the third leading cause of cancer deaths amongst men and women. (Photo via Getty Images)

Colon cancer is gaining traction online, as recent research from the American Cancer Society shows it's killing more younger people than ever. As more Canadians ask questions surrounding symptoms and first signs of colon cancer, and seek information on screening and testing, it's important to stay informed. Knowing whether colon cancer is treatable and understanding its causes, especially in women, can help you in your health journey. Here's what you need to know.

A cancer statistics report released in January indicated colorectal cancer is the first leading cause of cancer death amongst men younger than age 50. It's also the second deadliest cancer for women in the same age group, behind breast cancer.

That's compared to the late-1990s, where colorectal cancer was the fourth-leading cause of cancer deaths among both men and women under 50.

"The continuous sharp increase in colorectal cancer in younger Americans is alarming," American Cancer Society senior vice president of surveillance and health equity science Dr. Ahmedin Jemal said in a statement. Between both sexes, colorectal cancer ranks third amongst overall cancer deaths.

The report also estimated in 2024, the United States will see more than 152,000 new cases of colorectal cancer amongst men and women. Out of all cases for the year, there could also be more than 53,000 deaths. For the first time ever, more than two million new overall cancer cases are projected for 2024.

In Canada, it was estimated in 2023 that 24,100 Canadians will be diagnosed with colorectal cancer, and 9,300 Canadians will die from it — representing 11 per cent of all cancer deaths in 2023.

But what exactly is colorectal (colon) cancer, and how can you reduce risks? Here's what you need to know.

What is colorectal cancer?

Colorectal cancer is a disease that affects your large intestine (colon) or your rectum (the end of the colon).

Colon and rectal cancers are grouped together as colorectal cancer because the two organs are made of the same tissues without a distinct border between them.

When cells in the colon or rectum no longer grow or behave normally, the changes may lead to non-cancerous tumours, precancerous conditions (i.e. adenomas) or colorectal cancer.

Colorectal cancer can affect anyone at any age. "Black Panther" actor Chadwick Boseman died from the disease at age 43 and Raven-Symoné's younger brother, Blaize Pearman, at age 31. However, 93 per cent of cases in Canada occur in adults aged 50 and over.

Like the United States, colorectal cancer is also the third most common cancer in Canada, according to federal cancer statistics. Roughly one in 14 men will be diagnosed with colorectal cancer in their lifetimes, alongside one in every 18 women.

"Black Panther" actor Chadwick Boseman died of colon cancer at age 43 in 2020. (Photo via Getty Images)
"Black Panther" actor Chadwick Boseman died of colon cancer at age 43 in 2020. (Photo via Getty Images)

What are the first signs and symptoms of colon cancer?

Colorectal cancer may not present any significant signs or symptoms in its early stages, making it all the more important to stay up-to-date on your colon health and get screened regularly. If caught in its early stages, colorectal cancer is 90 per cent curable.

According to the American Cancer Society, a polyp can take as long as 10 to 15 years to develop into cancer. Therefore, symptoms often only start appearing once a tumour grows and affects the surrounding organs and tissues. The early signs of colorectal cancer are often similar to other health conditions, including anemia and irritable bowel syndrome.

Dr. Monika Krzyzanowska, a medical oncologist at the Princess Margaret Cancer Centre, told Yahoo Canada in a previous interview that one of the early signs of the disease is a change in bowel habits."[People] may not be going as often [to the bathroom] as they usually do," she told Yahoo Canada. "The calibre of your stool may change. For example, it can become thinner or more narrow."

Krzyzanowska noted that abdominal pain, bleeding and unexplained weight loss are causes for concern, alongside iron-deficiency anemia. "One of the things people may not know [to pay attention to] is iron-deficiency anemia," she added. "They may be feeling tired, go see their family doctor and are found to be anemic. This can sometimes be an initial presentation of colon cancer."

old man clutching stomach with hands wearing blue jeans and plaid shirt, colon cancer
Constipation, diarrhea, and abdominal pain may be signs of colon cancer (Photo via Getty).

Symptoms of colorectal cancer in women are the same as in men, and may include:

  • Diarrhea

  • Constipation

  • Narrow stool (compared to average)

  • Blood in the stool

  • Unexplained weight loss

  • Anemia

  • Abdominal cramps and pain

  • Nausea and vomiting

  • Pain or discomfort in the rectum

  • Bleeding from the rectum

Krzyzanowska said the urgent symptoms you should never ignore are "any sort of severe abdominal pain or abdominal pain associated with nausea, vomiting and an inability to pass stool," as they could be symptoms of a bowel obstruction.

Who is at risk for colon cancer?

Colorectal cancer can affect anyone, but people living with inflammatory bowel disease (Crohn's disease and ulcerative colitis) are at an increased risk compared to the general population.

The average age of a colorectal cancer diagnosis is in people aged 50 and over, where the risk increases with age.

Risk factors include a family history of polyps and colon cancer, obesity, smoking, alcohol, sedentary behaviour and a diet high in processed and red meat.

"Ironically, a lot of the lifestyle factors [that are good for colon health] are good for other things as well," said Krzyzanowska, who added "having a healthy diet, not smoking and having a good weight" can decrease your risk of the disease.

Why are colorectal cancer rates rising among young people?

No one can say for certain why colorectal cancer numbers are rising in young people. However, some experts theorize increased incidence rates could be linked to dietary or lifestyle factors.

A sedentary lifestyle, obesity, smoking, heavy alcohol use, low-fiber, high-fat diets, diets high in processed meats and other environmental factors have all been linked to colorectal cancer. But more research must be done to explain why people under 50 are now at an increased risk of developing the disease.

Colorectal cancer cases are rising amongst younger people, but experts aren't sure why. (Photo via Getty Images)
Colorectal cancer cases are rising amongst younger people, but experts aren't sure why. (Photo via Getty Images)

Should younger people get screened for colon cancer?

Despite increased colorectal cancer rates among young people, Canada's screening policies still recommend waiting until age 50 for average-risk adults.

But some studies note lowering the screening age "may be justified."

At present, an average-risk adult is someone between ages 50 and 74 with no first-degree relative — such as a parent, sibling or child — who has been diagnosed with colorectal cancer. If you have a personal history of colon cancer, ulcerative colitis, Crohn's disease or other higher-risk factors, your doctor may suggest you begin screening early.

While a stool test is no one's idea of a good time, it saves thousands of lives every year.

"Colon cancer is one of the few cancers that we do have an effective screening test," said Krzyzanowska. "The evidence is quite strong that screening for colon cancer can decrease the incident [rate] and increases survival, so if you're in the right age group, go ahead and get screened."

A standard abdominal ultrasound won't show a tumor in your colon or rectum, but it can show whether the cancer has spread to other organs in your abdomen (for example, liver or pancreas).

Similar to cervical cancer screening, screening for colorectal cancer looks to find and identify polyps before they ever become cancerous. "If you're picking up a polyp and you can remove it, then you're moving the diagnosis a lot earlier in the disease course," Krzyzanowska said.

"I know it's scary to think you might have cancer, but it's better to be picked up early or at the pre-cancerous stage."

Colorectal cancer is "treatable, but you need to be availing yourself to the screening tests that are available," she said. "If you're having any kind of symptoms, seeking medical attention early" can save your life.

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