Millennials Grapple with Colorectal Cancer

Dr Gunes Dr Hossami

Dr. Adem Günes & Dr. Abdulla El-Hossami

Millennials Grapple with Colorectal Cancer

Colorectal Cancer starts in the colon or rectum and is sometimes referred to as bowel cancer, colon cancer or rectal cancer. A prolonged change in bowel habits, which may be reflected in the consistency of the stool, frequent bouts of diarrhea and persistent constipation are typical first signs of Colorectal Cancer. Blood in the stool, persistent abdominal pain and gas, fatigue and unexplained weight loss are also common symptoms of Colorectal Cancer. A feeling that the bowel does not empty completely, considered with the other symptoms, may also indicate the presence of Colorectal Cancer. When these signs appear this does not necessarily signify the onset of the disease but may instead be an indication that it has already taken root in the body. Rarely displaying any signs in its early stages the appearance of the symptoms should prompt one to seek immediate medical attention.

Understanding Colorectal Cancer
A recent study in the US produced some alarming results. This study showed that the incidence of Colorectal Cancer in Americans under the age of 55 was sharply on the increase with persons born in 1990 now having twice the risk of getting Colon Cancer and four times the risk of ending up with Rectal Cancer at the same age had they been born in the 50s. 500 000 cases of Colorectal Cancer from 1974 to 2013 were studied to arrive at this conclusion. Rebecca Siegel, lead author of the study and an epidemiologist at the American Cancer Society says no tangible evidence as to the reasons behind the increase was found. Siegel did point out however that the rise in obesity has closely mirrored the trends in Colorectal Cancer while indicating that it may not necessarily be a direct cause of the disease. The correlation, she says, may be shared common risks including unhealthy diets and sedentary lifestyles.

Colorectal Cancer Screening Guidelines
Screening guidelines for Colorectal Cancer published by the Centres for Disease Control and Prevention (CDC) indicate that 50 is the optimal age to start screening for this disease and continuing on until the age of 75 years. A typical screening will normally use high-sensitivity fecal occult blood testing, colonoscopy or sigmoidoscopy. Given this latest development (with the disease appearing in much younger persons), these guidelines would seem due for an urgent revision.

A slightly dissenting view is expressed by Dr H. Gilbert Welch, a professor at the Dartmouth Institute for Health Policy and Clinical Practice. Dr Welch believes the numbers are “too small to warrant the attention this trend is getting” and points out that the annual rate of increase of Colorectal Cancer among people in their 20s has risen by only one to two cases for every 200 000 people. Dr Welch further asserts that for all adults under the age of 50, the rate of Colorectal Cancer in 2013 was only seven cases per 100 000 people. Rates for adults over 50 actually dropped.

A question of perspective, then. The statistics do however tell a story and although the jump in the rate may be small it does translate to large absolute numbers. The direction to take would perhaps be to focus on more efficient testing, for example the Cologuard stool test approved the FDA in 2014 and which can be administered at home. More emphasis should also be laid on the necessity of leading a healthy lifestyle that incorporates eating the right foods and getting enough exercise and maintaining a healthy weight.

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