The number of cases of colon and rectal cancer has been rising in adults under 55 years old since the 1990s, particularly among non-white people.
Since the passing of actor Chadwick Boseman at age 43, there has been increased awareness of colorectal cancer (CRC) in the young, and its disproportionate impact on Black Americans. Boseman represents thousands of young people in the prime of their lives who will die of colorectal cancer within the United States and abroad. In turn, advocates and clinical providers are actively working on strategies to explore the delay in diagnosis and alleviate unique challenges early-age onset colorectal cancer patients face.
The number of new cases of colon and rectal cancer has been rising in adults under the age of 55 since the 1990s. Furthermore, African Americans bear a disproportionate burden, with an incidence of CRC that is more than 20 percent higher than in whites with an even larger difference in mortality. In particular, African Americans are more often diagnosed with CRC at an earlier age and with more advanced disease.
Why are hundreds of young people, particularly those of color, inordinately dying of a cancer that is often 100 percent preventable with screening? In June 2020, more than 400 researchers, scientists, and patient or research advocates worldwide joined together virtually to develop pathways based on a 2019 published research blueprint designed to better study causation of early-age onset CRC. The types of questions and risk factors to be studied include diet in childhood; obesity at certain times in life; microbiome within the colon; antibiotic use in childhood; and gene and environment interactions.
Researchers also must take into consideration how we can study interlinked factors in existing studies and data repositories, and when new approaches must be explored. This will require multilevel research on the dynamic relationship between individual factors and macroenvironmental influences, plus disparities of race in early-age onset CRC.
To achieve requisite numbers and diverse representation needed to answer the proposed questions, these trials and studies must be international in scope. The National Cancer Institute and Centers for Disease Control and Prevention have been exceptionally engaged, seeking funding and collaborative pathways to increase public health initiatives in response.
The medical and scientific communities feel the great loss of countless parents, children, partners, employers, and families who have lost loved ones to this cancer. We must all be committed to harnessing our collective energy and talents across borders and oceans to address and confront early-age onset colorectal cancer with humanity and equity.