Steven Bushong
Senior Manager of Strategic Communications, Colorectal Cancer Alliance
The tragic loss of a superstar moved huge numbers of people and the media to ask, ‘What is colorectal cancer and does it really affect young people, too?’
From his breakout role as Jackie Robinson in “42” to his brilliant portrayal of T’Challa in “Black Panther,” Chadwick Boseman had amassed a passionate following across generations and races. The sudden news of Boseman’s death, an unfortunate hand dealt by young-onset colorectal cancer, stunned the world.
Overnight, Google searches for “colon cancer” rocketed to trending status and dozens of major news outlets talked about the increasing incidence of young-onset colorectal cancer, which occurs in people younger than age 50. Not since journalist Katie Couric’s colonoscopy on live television had so many people been curious about this disease, the second-leading cause of cancer deaths in the United States among men and women combined.
“Somberly, we share that young-onset colorectal cancer is on the rise and cuts short thousands of lives every year,” said Michael Sapienza, CEO of national nonprofit Colorectal Cancer Alliance, in a statement after Boseman’s death. “Even superheroes can get colorectal cancer.”
Understanding the disease
Colorectal cancer has long-affected people later in life, which is why screening traditionally began at age 50. But colorectal cancer incidence has increased in adults 20-39 years old since the mid ‘80s and in adults ages 40-54 years since the mid ‘90s.
And while mortality rates have decreased in recent decades among individuals diagnosed over age 50, mortality rates in individuals diagnosed under the age of 50 have increased by 1.3 percent per year.
These data moved the United States Preventive Services Task Force (USPSTF) to release a draft recommendation to lower the screening age from 50 to 45 for average-risk individuals. If this recommendation is formally adopted in 2021, people age 45 and older will, in most cases, be eligible for insurance reimbursement for CRC screening.
Research is underway to identify the cause behind the noted rise of young-onset colorectal cancer, including projects funded by the Colorectal Cancer Alliance. Hypotheses under investigation include diet, physical activity, smoking, and alcohol consumption, as well as the role of the microbiome and environmental exposures before and after birth.
Protecting yourself
Young-onset colorectal cancer is a highly preventable disease with routine screening. When caught early, it’s also highly treatable. Ninety percent of patients with localized tumors live five or more years after diagnosis.
“The No. 1 way to prevent colorectal cancer, if you’re above age 45, is with screening,” said Dr. Laura Porter, the Colorectal Cancer Alliance’s Medical Affairs Senior Consultant. “For men and women who are younger than the standard screening age, they must pay attention to their bodies, speak up if something is wrong, and keep pushing their doctors for answers.”
Porter’s advice is reinforced by the findings of a recent Colorectal Cancer Alliance survey of young-onset patients and survivors. According to respondents, 49 percent had no knowledge of colorectal cancer symptoms prior to their diagnosis, 62 percent said they waited more than three months to see a doctor after symptoms began, and 75 percent said they saw two or more doctors before receiving a diagnosis.
Symptoms of colorectal cancer include blood in the stool, changing bowel habits, and abdominal discomfort, among others.