Colorectal cancer diagnoses among younger people have skyrocketed in recent years. A staggering 20% of cases in 2019 were in people younger than 55, up from 11% in 1995.
The trend is particularly scary because doctors are still trying to figure out what’s causing it — and symptoms so often fly under the radar.
But a new study has revealed a shocking relationship between early-onset colorectal cancer and a common condition that affects millions of Americans.
The study, conducted by a research team in Korea, included over one million subjects under age 50 categorized into three populations: those with nonalcoholic fatty liver disease (NAFLD), those without, and those with borderline NAFLD.
As the name implies, NAFLD is marked by excess fat in the liver of people who consume little or no alcohol.
The primary cause is obesity, along with metabolic risk factors such as Type 2 diabetes, high blood pressure, high cholesterol, and obstructive sleep apnea.
NAFLD is present in 75% of people who are overweight and in 90% of those who are severely obese. It is the most common form of childhood liver disease in the US.
Impacting between 80 million and 100 million American, NAFL is known as the “silent epidemic” because it often has no symptoms or nonspecific symptoms, such as fatigue, brain fog, and abdominal pain.
“Although common, NAFLD is often hidden or missed in routine medical care,” Dr. P. Barton Duell, writing chair of the American Heart Association said in a statement.
The Korean research team found that people under the age of 50 with a history of NAFLD were nearly 24% more likely to be diagnosed with colon cancer compared to those without the condition.
Those diagnosed as borderline had a 12% higher chance of developing the cancer compared to those without a history of NAFLD.
They found a more substantial risk among men, people aged 20-29, and people without diabetes. Early-onset colorectal risk was observed only in the left colon and rectum.
Though the researchers urged further investigation, they believe the inflammation caused by NAFLD could spread to the colon, damaging cellular DNA in the process and ultimately leading to the formation of cancer cells.
Early onset colorectal cancer is particularly dangerous as the disease tends to be diagnosed in the disease’s later stages, making it harder to treat and cure, according to doctors who expect colon cancer to cause about 53,000 US deaths this year.
“NAFLD is positively associated with an increased risk of early-onset colorectal cancer, particularly in the left colon and rectum,” the researchers noted. “These findings highlight the need for multifaceted preventive strategies, including lifestyle interventions and expanded screening for younger populations with NAFLD.”
Due to the stealth nature of NAFLD, experts stress the importance of screening for fatty liver in patients with risk factors, even if there are no signs or symptoms of liver disease.
Blood tests can measure inflammation in the liver, while imaging tests, such as ultrasounds or CT scans, can visually assess the organ’s appearance.
For those diagnosed with NAFLD, experts agree that a low-carbohydrate diet and regular exercise are key to managing the disease.
Nonalcoholic steatohepatitis (NASH), the more severe, progressive form of NAFLD, leads to swelling or inflammation of the liver and damage to liver cells. NASH is predicted to become the leading cause of liver transplantation in the U.S. by 2025.