Colon cancer on the rise in younger adults

Preventive screenings cited for drop in number of older Americans diagnosed.

Early screening and prevention is being credited for putting a dent in the incidence rate of the second deadliest cancer in men and women.

But researchers and physicians say a more troubling statistic has been the increase in colorectal cancers (CRC) — cancers of the colon or rectum — in those ages 20 to 49, according to a report published online by JAMA Surgery, a professional medical journal.

“We’ve had younger patients pop up,” said UC Health oncologist Dr. Olugbenga Olowokure, known warmly to patients as Dr. Benga. “In older patients there’s been a significant drive of encouraging (them) to get colonoscopies in general.”

Colon cancer is the third most common cancer in men and women and the second leading cause of cancer-related deaths — with an estimated 142,820 new cases and 50,830 deaths in the U.S. in 2013, according to the 2014 study.

Study researchers analyzed age disparities in nearly 400,000 cases of colorectal cancers in the U.S. from 1975 through 2010.

From 1998 through 2006, the incidence of colon cancers declined 3 percent per year in men and 2.4 percent in women — a decrease largely attributed to increased screenings for adults over age 50, according to research by Dr. Christina E. Bailey, of the University of Texas MD Anderson Cancer Center, and her co-authors.

Those screenings, primarily in the form of a colonoscopy every 10 years to catch polyps that can become cancerous, aren’t recommended for those under age 50 — a subset of the population in which colon cancer “appears to be increasing and those patients are more likely to present with advanced disease,” according to the study.

University of Cincinnati professors Frank and Rosario Davis, who’ve been married 33 years, lost their 28-year-old son Rafe Davis to stage 4 colon cancer in early 2014.

Rafe Davis was just 25 when he was diagnosed with the deadly cancer. He’d previously complained of discomfort in his digestive system, and his doctor thought it may have been from a lack of fiber or water.

Frank Davis said a different doctor then tested his son for irritable bowel and a gluten intolerance before it was discovered Rafe had a hernia. He had surgery for the hernia, and later was given a colonoscopy on an “off chance” and a large tumor was found.

“They attacked fast,” Frank Davis said. “(The cancer) was found one week and removed the next.”

Rafe Davis moved back to Cincinnati, from San Francisco, to undergo 15 months of chemotherapy and radiation treatment with Dr. Olowokure.

“The scans and blood work showed no active cancer; we kept holding our breaths this was going to work out,” Frank Davis said.

But by the middle of 2013, his son’s cancer had re-emerged in the bladder and bowels, Frank Davis said. The 28-year-old musician, writer and auto mechanic died Jan. 3, 2014.

“There’s no light shed on the cause; he was always slim, ate fairly healthy and was physically active,” Frank Davis said. “Rafe didn’t fit any kind of profile. No family history. It’s terribly baffling.”

The study authors estimate that by 2020 and 2030, the incidence rate of colon cancer will increase by 38 percent and 90 percent, respectively, for patients 20 to 34 years old. During those same periods, cases of the cancer in patients 50 and older will continue to decrease 23.2 percent and 41.1 percent, respectively.

“The increasing incidence of CRC among young adults is concerning and highlights the need to investigate potential causes and external influences such as lack of screening and behavioral factors,” the authors conclude.

Dr. Olowokure said suggested risk factors for colon cancer include obesity and diabetes.

“As the population tends to get somewhat larger, we need to continue education,” Olowokure said, emphasizing the need for regular exercise and visits to a primary care physician.

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