Colorectal Cancer Surging in Young Adults: Spira Care’s Dr. Johnston on Reducing Your Chances
Thinking of putting off your colonoscopy? This might change your mind.
The American Cancer Society shows a major shift in age demographics for colorectal cancer. This type of cancer is used to describe colon cancer and rectal cancer, depending on where the cancer begins.
- Nearly half of all new colorectal cancer cases occur in adults under 65, which is up 27% from 1995.
- Colorectal cancer is now the deadliest cancer in people under 50 and the second deadliest cancer overall in the United States.
- About three out of four adults under 50 with colorectal cancer are diagnosed at an advanced stage.
The recent deaths of “Dawson’s Creek” actor James Van Der Beek at 48 and “Black Panther” star Chadwick Boseman at 43 to colon cancer highlight the risk for younger adults.
“It’s definitely very concerning,” Spira Care Shawnee Physician Dr. Isaac Johnston said. “I have seen more patients in the past couple of years under 45 requesting colonoscopies. As a physician, I need to be much more diligent when looking for symptoms of colorectal cancer for patients even in their 20s or 30s.”
Risk Factors of Colorectal Cancer
Colorectal cancer occurs when cells in the colon or rectum (at the end of the colon) grow out of control.
“We don’t know exactly why there is such a spike in younger people getting colorectal cancer, but part of it may have to do with the fact that many of the risk factors have increased for adults under 50,” Dr. Johnston said.
According to Dr. Johnston, risk factors include:
- Obesity
- Type 2 diabetes
- Eating processed foods, particularly processed meats (hot dogs, sausage, bacon, ham, packaged lunch meats)
- High consumption of red meat
- Sugar-sweetened beverages
- Smoking
- High alcohol consumption
“Patients at higher risk for colorectal cancer are Native Americans, African Americans and Alaska Natives,” Dr. Johnston said. “Being more sedentary versus having an active lifestyle is another risk factor. A typical American diet is low in fiber, high in fat and high in processed foods, and those are all risk factors for colorectal cancer.”
Symptoms of Colorectal Cancer
“Feeling fatigue or having blood in the stool are early signs you might have colorectal cancer,” Dr. Johnston said. “As the cancer grows and gets bigger, you have unintended weight loss. The cancer can cause bowel blockages. The survival rate is better when you catch it early before it spreads in the lymph nodes, liver and the rest of the body.”
Other symptoms include:
- A change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days
- A feeling that you need to have a bowel movement that’s not relieved by having one
- Rectal bleeding with bright red blood
- Cramping or abdominal (belly) pain
Take Action
According to the American Cancer Society, many colorectal cancer deaths can be prevented. Half of people diagnosed before 50 are ages 45 to 49, and that’s the age range when people with an average risk are eligible for colorectal cancer screening. Only 37% of this age group are screened.
Colorectal cancer might not cause symptoms right away, making regular screening crucial for early detection. Most colorectal cancers start as a growth known as a polyp on the inner lining of the colon or rectum. Most polyps are noncancerous, but some can change into cancer over time.
“The two most common colorectal cancer screening tests we order are the colonoscopy and the Cologuard DNA-based stool test,” Dr. Johnston said. “It’s nice to have the Cologuard option that is non-invasive, and you can take this test at your house. They mail the box to your door, and you send back a stool sample in the mail. If nothing is found, your test is good for three years. The colonoscopy is a great option, as you don’t need to get another screening for 10 years if they don’t find any polyps, and your risk is low. Any polyps can be removed during the procedure. You do the prep work the night before and need a ride after the exam since you’re asleep during the procedure.”
Dr. Johnston notes who should get screened before the age of 45:
- People with inflammatory bowel disease
- One first degree relative who had colorectal cancer before the age of 60
- Start getting screened at age 40 or a decade before the relative was diagnosed – whichever comes first.
Prevention starts with Primary Care
When it comes to the prevention of colorectal cancer, your primary care provider can help identify issues early. If you have a Blue KC plan with exclusive access to Spira Care, you can take advantage of nine Kansas City area Care Centers, where you have access to a Care Team to help you navigate your health journey.
“We take time to review preventive screenings each time someone visits our Spira Care Center,” Dr. Johnston said. “We can order a colorectal cancer screening test and review the results with you. If the patient decides to do the colonoscopy, we typically use gastroenterologists (GI specialist). Usually, the procedure is done in an outpatient clinic, making it very convenient for patients. We have Care Guide RNs who can coordinate any colonoscopy referrals, answer your questions, facilitate communication with the specialist’s office and follow up on patient appointments.”
Dr. Johnston recalls helping with one patient’s colorectal cancer journey.
“He was 44 when I saw him for his wellness exam, and he wasn’t due for a screening for a year. At the end of the checkup, he says, ‘by the way, I don’t think it’s anything big, but I should probably tell you about a month ago, I had some bright red blood in my stool. It was a one-time thing and hasn’t happened since, but wife told me I should tell you.’ I ended up ordering him a colonoscopy, and he was diagnosed with early-stage colon cancer. They were able to remove it, and he gets colonoscopies to monitor it. If he had waited another year, it could have advanced. Cancer screenings might not be on the radar for young, healthy adults, but it’s good to review symptoms at appointments to make sure nothing is off!”
If you are experiencing a medical emergency, call 911 or go to the nearest Emergency Department. In case of a mental health emergency, call or text 988.
Source: American Cancer Society
Dr. Isaac Johnston is a family practice physician focused on caring for people of all ages. He enjoys working with infants and children, adults and older adults alike. Previously, Dr. Johnston provided clinical, hospital and obstetric care. At Spira Care, he helps members manage their acute and chronic concerns, preventive care needs and partner with them to achieve their optimal health and wellness goals.
