More kids and teens are getting colorectal cancer. And when it does strike, researchers say the disease manifests differently than in adults.
Over the past two decades, colorectal cancers have exploded fivefold among children ages 10 to 14, more than tripled among teens aged 15 to 19 and nearly doubled among young adults ages 20 to 24.
New data suggests that when people age 21 and younger are diagnosed with colorectal cancer, it’s more likely to be serious — stage 3 or 4.
According to researchers, this aggressive and advanced cancer often returns after treatment and can lead to death.
Researchers looked at 84 patients aged 21 years old or younger diagnosed with colorectal cancer. By the end of the study period, nearly half had died from the disease.
The median age of patients studied was just 16.5 years old. A vast majority of them (80%) didn’t have family history of colorectal cancer.
By the time they were diagnosed, more than half had reached stage 3 — meaning the cancer had spread locally — and 29% stage 4 — the cancer had spread to distant parts of the body.
The patients went through a number of different treatments, including surgery, chemotherapy, radiation and creating an ostomy, an alternative opening for waste to exit the body.
Still, the cancer returned in 36.9% of patients and almost all had become late stage. In total, 38 (45.2%) patients died from colorectal cancer.
Overlooked symptoms, delayed diagnosis
Young people are experiencing poor outcomes partly because the cancer is aggressive, researchers say, but also because diagnoses are delayed.
Patients’ symptoms are often overlooked “due to low rates of this type of cancer in young people.”
Many symptoms also overlap with less serious conditions like hemorrhoids or irritable bowel syndrome.
Here are the most common symptoms patients in the study reported before getting a diagnosis:
- Back and abdominal pain: Abdominal pain can look like cramps, incomplete emptying, gas or back pain that won’t go away with rest, stretching or physical therapy.
- Change in bowel habits: This includes diarrhea, constipation or unusually narrow ribbon-like stool.
- Unexplained weight loss: Cancer patients have a hard time keeping weight on even when eating appropriately, as cancer consumes large amounts of energy.
- Rectal bleeding: This might look like bright red streaks mixed into the stool, dark red blood or black, tarry stools.
The study authors urge medical providers to treat symptoms seriously in younger patients, especially unexplained weight loss and rectal bleeding
Following a physical exam and reviewing the patient’s medical history, doctors may order a stool and blood test for screening. If warranted, the doctor will order imaging and a colonoscopy, where samples are taken and analyzed to confirm a cancer diagnosis.
“As early-onset adult cancers are seen in younger and younger patients, the logistical considerations of adult and pediatric care teams and carefully tailored treatment regimens are paramount,” they said.
Early detection is key. When colorectal cancer is caught in stage 1 and stage 2, the five year survival rate is about 90%.
Researchers are still trying to pin down why so many young people are falling ill. They believe it’s a combination of obesity, a Western diet (processed, red meat and sugar), environmental exposures like microplastics, pesticides, antibiotics and infections like E. coli
