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Young People Are at Risk for Colorectal Cancer Too

Young people may not realize they are also at risk of colorectal cancer, but the good news is that treatment exists.

Colorectal cancer cases are rising in young people. By one estimate, about 12 percent of all cases diagnosed in 2020, or about 18,000 people total, will be among those younger than 50.

“There is a misunderstanding that colorectal cancer is a cancer of older patients and can only be detected by an invasive procedure, a colonoscopy,” said Scott Kopetz, MD, a professor of gastrointestinal medical oncology at The University of Texas MD Anderson Cancer Center. “People are taught at a young age not to talk about bowel function and are often hesitant to bring up symptoms until too late.”

Distant colorectal cancer, which means it has spread or metastasized to various parts of the body, is 14 percent, according to the American Cancer Society. But localized colorectal cancer, which means it has not metastasized, is 90 percent.

“We and others are also working hard to understand why there are now more young patients being diagnosed with colorectal cancer than years past, even though incidence of colorectal cancer in older patients in declining,” said Kopetz. “The treatments and outcome of younger patients are different and requires a better understanding of what is unique about their tumors.”

Kopetz advised anyone with bowel movement changes to consult a doctor. And he recommended those with a family history of colorectal cancer get screened at least 10 years before the age their family member was diagnosed. If a colonoscopy is not accessible, Kopetz said you can use self-screening tools at home under your doctor’s direction. “The best screening test is one that is actually completed,” he added.

As far as treatment options go, Kopetz noted that advancements including liquid biopsies have allowed doctors to individualize patients’ post-surgical therapy. “The future of colorectal cancer treatments will undoubtedly use liquid biopsies to guide the use of new therapies to reduce the risk of recurrence after surgical resection,” he explained.

Another way treatment has improved recently is doctors can study the environment of bacteria, called the microbiome, in the bowels to understand a patient’s potential response to a certain therapy, Kopetz said. He added that for individuals whose cancer has metastasized, molecular tests can help doctors pinpoint colorectal cancer subtypes and the appropriate treatment.

Immunotherapy, which bolsters or draws upon the defenses of a patient’s immune system to target cancerous cells, can help treat certain cancers, including lung and skin, according to the Cancer Research Institute and the American Cancer Society. But it’s also a promising horizon for colorectal cancer treatment, Kopetz explained. “We anticipate new treatments that utilize immunotherapy combination agents to engage the body’s immune system and target disease,” he said. “These strategies will likely involve tumor vaccines designed for specific characteristics of the cancer or will use novel cellular therapies to treat patients with immune cells that are engineered to target the cancer.” Knowing to spot the signs and get screened are two critical steps. The earlier a doctor can make a potential diagnosis, the better. After all, science is on your side.

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