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Don’t stall — your butt is on the line.
Nearly 53,000 Americans are expected to die of colorectal cancer this year, making it one of the deadliest cancers in the US. Though the death rate has been declining in older adults, it has been steadily rising among people younger than 55 since the 1990s.
Because of this worrisome trend, the US Preventive Services Task Force (USPSTF) lowered its recommendation for starting colorectal cancer screening from age 50 to 45 in 2021. The American Cancer Society (ACS) made the same suggestion in 2018 for people at average risk for the disease.
New research out Monday in the Journal of the American Medical Association shows the guidance is working. Colorectal cancer screening among Americans aged 45 to 49 rose by 62% from 2019 to 2023.
“It’s not only thrilling to see the increase in colorectal cancer screening among younger adults, but also how it likely ties into rises in earlier stage diagnosis as noted in the other ACS-led paper,” said lead study author Jessica Star, an ACS associate scientist for cancer risk factors and screening surveillance research.
The increase in screenings appears to have paved the way for an uptick in diagnoses of early-stage colorectal cancer among 45- to 49-year-olds. Early stage typically means the disease hasn’t spread beyond the colon or rectum.
Early-stage diagnoses in 45- to 49-year-olds rose from 11.7 cases per 100,000 people in 2021 to 17.5 cases per 100,000 people in 2022, according to a study also published Monday in JAMA.
Early detection can significantly improve survival rates and treatment outcomes.
“We still have a long way to go,” Star said. “Screening for colorectal cancer in ages 45-49 remains suboptimal and has not increased equitably by both educational attainment and insurance status.”
Colonoscopies, when a doctor uses a long, thin, flexible tube to examine the colon for abnormalities, spiked 43% and stool-based testing jumped more than 5-fold from 2019 to 2023 in the 45 to 49 group.
Every racial and ethnic group underwent more screenings, as people without a high school diploma and uninsured people sat on the sidelines.
ACS warns that screening is more important than ever. Advanced-stage colorectal cancer has risen 1.7% to 2.9% annually since 2004 among adults younger than 45 and even more sharply in the past decade in people 45 to 54.
“I’ve been in practice for 25 years, and I can tell you over the last 10 years and particularly over the last five years, we have seen a tremendous increase in cancer in young patients,” Dr. David Rivadeneira — director of the Northwell Health Cancer Institute at Huntington Hospital and a colorectal cancer specialist, who was not involved in the new research — told The Post.
“We never used to see this,” he added. “This used to be a diagnosis you give to someone in their mid-50s, 60s, 70s or 80s.”
Scientists aren’t exactly sure why colorectal cancer patients are getting younger. They have pointed the finger at the prevalence of obesity, sedentary lifestyles, the Western diet, excess sugar consumption and environmental factors such as pollutants in the air, soil and water.
Rivadeneira noted that he now recommends a colonoscopy for people with any concerning symptoms, no matter their age.
Common colorectal cancer symptoms include changes in bathroom habits, blood in stool, stomach pain or cramping, unexplained weight loss and fatigue.
Surgery is the primary treatment for most colon cancers, with survival rates influenced by the stage of the disease.
Stage 1 colon cancer is curable 90% of the time with just surgery and no other treatment, Rivadeneira said.
Stage 2 — when the tumor is larger and has grown through the bowel wall but has not spread to nearby lymph nodes — has a survival rate of 80% to 85%.
“When you go to Stage 3, now it’s spread to the lymph nodes, it drops down to the 60% mark,” Rivadeneira said.
“So the sooner the tumors are detected, the higher the cure rate and again, no need for chemotherapy or any additional treatment besides the surgery.”
